Highly purified batches of pharmaceutical grade migalastat and methods of producing the same

ABSTRACT

Provided are methods of producing a batch of 1,2,3,6-tetrapivaloyl-D-galactofuranoside; 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside; intermediate grade migalastat hydrochloride; and/or migalastat hydrochloride. Also provided are methods of determining the purity of a batch of 1,2,3,6-tetrapivaloyl-D-galactofuranoside; 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside; intermediate grade migalastat hydrochloride; and/or migalastat hydrochloride. Also provided are methods of distributing a batch of 1,2,3,6-tetrapivaloyl-D-galactofuranoside; 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside; intermediate grade migalastat hydrochloride; and/or migalastat hydrochloride. Also provided are methods of assessing suitability of migalastat hydrochloride for medical use.

BACKGROUND

Migalastat was developed for the treatment of Fabry disease. It is desirable to develop methods for producing batches of migalastat hydrochloride that have increased purity.

SUMMARY

Provided are methods of producing a batch of 1,2,3,6-tetrapivaloyl-D-galactofuranoside, the methods comprising: reacting D-(+)-galactose with pivaloyl imidazole to produce 1,2,3,6-tetrapivaloyl-D-galactofuranoside, wherein the 1,2,3,6-tetrapivaloyl-D-galactofuranoside contains 3% area or less of Compound B.

Also provided are methods of determining the purity of a batch of 1,2,3,6-tetrapivaloyl-D-galactofuranoside produced by reacting D-(+)-galactose with pivaloyl imidazole to produce 1,2,3,6-tetrapivaloyl-D-galactofuranoside, the method comprising performing a chromatographic test on the batch to determine that the batch has 3% or less of Compound B.

Some embodiments comprise performing high performance liquid chromatography (HPLC) on the batch to identify a peak associated with the Compound B, and determining that the area under the second peak is 3% or less of a total area under the identified HPLC peaks. In some embodiments, the batch has 2.9% area or less of the Compound B. In some embodiments, the batch has from 1.5-2.5% area of the Compound B.

Also provided are methods for determining an amount of Compound B in a 1,2,3,6-tetrapivaloyl-D-galactofuranoside sample, the methods comprising synthesizing Compound B and using the synthesized Compound B as a reference standard in high performance liquid chromatography (HPLC) test conducted to determine the amount of the Compound B in the 1,2,3,6-tetrapivaloyl-D-galactofuranoside sample.

Also provided are methods of producing a batch of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside, the methods comprising: activating 1,2,3,6-tetrapivaloyl-D-galactofuranoside with trifluoromethanesulfonic acid anhydride; reacting the activated 1,2,3,6-tetrapivaloyl-D-galactofuranoside with water to produce 1,2,3,6-tetrapivaloyl-α-L-altrofuranoside; activating the 1,2,3,6-tetrapivaloyl-α-L-altrofuranoside with trifluoromethanesulfonic acid anhydride; reacting the activated 1,2,3,6-tetrapivaloyl-α-L-altrofuranoside with sodium azide to produce 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside; and isolating the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside, wherein the isolated 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside contains 0.6% area or less of 1,2,3,6-tetrapivaloyl-D-galactofuranoside, 0.3% area or less of Compound E, 0.3% area or less of Compound G, 3% area or less of Compound J, 0.6% area or less of Compound I, 0.3% area or less of Compound K, 1% area or less of Compound N, and 0.3% area of less of Compound O.

Also provided are methods of determining the purity of a batch of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside produced from 1,2,3,6-tetrapivaloyl-D-galactofuranoside, the method comprising performing a chromatographic test on the batch to determine that the batch has 0.6% or less of 1,2,3,6-tetrapivaloyl-D-galactofuranoside, 0.3% or less of Compound E, 0.3% or less of Compound G, 3% or less of Compound J, 0.6% or less of Compound I, 0.3% or less of Compound K, 1% or less of Compound N, and 0.3% or less of Compound O.

Some embodiments comprise performing high performance liquid chromatography (HPLC) on the batch to identify one or more of a first peak associated with the 1,2,3,6-tetrapivaloyl-D-galactofuranoside, a second peak associated with the Compound E, a third peak associated with the Compound G, a fourth peak associated with the Compound J, a fifth peak associated with the Compound I, a sixth peak associated with the Compound K, a seventh peak associated with the Compound N, and an eighth peak associated with the Compound 0, and determining that one or more of the area under the first peak is 0.6% or less of a total area under identified HPLC peaks, the area under the second peak is 0.3% or less of the total area under identified HPLC peaks, the area under the third peak is 0.3% or less of the total area under identified HPLC peaks, the area under the fourth peak is 3% or less of the total area under identified HPLC peaks, the area under the fifth peak is 0.6% or less of the total area under identified HPLC peaks, the area under the sixth peak is 0.3% or less of the total area under identified HPLC peaks, the area under the seventh peak is 1% or less of the total area under identified HPLC peaks, and the area under the eighth peak is 0.3% or less of the total area under identified HPLC peaks.

In some embodiments, the batch has 0.16-0.36% area of 1,2,3,6-tetrapivaloyl-D-galactofuranoside, 0.06% area or less of Compound E, 0.03% area or less of Compound G, 0.86-1.67% area of Compound J, 0.35% area or less of Compound I, 0.08-0.11% area of Compound K, 0.06-0.28% area of Compound N, and 0.12-0.17% area of Compound O. In some embodiments, the batch has less than 12 μg of Compound F per g of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside.

In some embodiments, the sodium azide is in DMSO, and the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is isolated by washing the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside with methanol and drying the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside under a vacuum, and the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has 0.01% w/w or less of DMSO.

Also provided are methods for determining an amount of one or more of 1,2,3,6-tetrapivaloyl-D-galactofuranoside, Compound E, Compound G, Compound J, Compound I, Compound K, Compound N, and Compound O in a 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside sample, the method comprising one or more of: synthesizing 1,2,3,6-tetrapivaloyl-D-galactofuranoside and using the synthesized 1,2,3,6-tetrapivaloyl-D-galactofuranoside as a reference standard in a high performance liquid chromatography (HPLC) test conducted to determine the amount of 1,2,3,6-tetrapivaloyl-D-galactofuranoside in the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside sample; preparing Compound E from 1,2,3,6-tetrapivaloyl-D-galactofuranoside and using the Compound E as a reference standard in an HPLC test conducted to determine the amount of Compound E in the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside sample; synthesizing Compound G from 1,2,3,6-tetrapivaloyl-D-galactofuranoside and using the synthesized Compound G as a reference standard in an HPLC test conducted to determine the amount of Compound G in the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside sample; isolating Compound J from a batch of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside produced from 1,2,3,6-tetrapivaloyl-D-galactofuranoside and using the isolated Compound J as a reference standard in an HPLC test conducted to determine the amount of Compound J in the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside sample; synthesizing Compound I from Compound D and then recrystallizing the Compound I in heptane, and using the recrystallized Compound I as a reference standard in an HPLC test conducted to determine the amount of Compound I in the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside sample; synthesizing Compound K from Compound F and then using the synthesized Compound K as a reference standard in an HPLC test conducted to determine the amount of Compound K in the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside sample; synthesizing Compound N from Compound F and then using the synthesized Compound N as a reference standard in an HPLC test conducted to determine the amount of Compound N in the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside sample; and isolating Compound O from a batch of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside produced from 1,2,3,6-tetrapivaloyl-D-galactofuranoside and using the isolated Compound O as a reference standard in an HPLC test conducted to determine the amount of Compound O in the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside sample.

Also provided are methods of producing a batch of intermediate grade migalastat hydrochloride, the methods comprising: reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst; allowing the reduced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside to undergo a rearrangement and hydrogenation to produce Compound S; adding sodium methoxide to the Compound S to produce migalastat; treating the migalastat with hydrochloric acid to produce an aqueous migalastat hydrochloride solution in hydrochloric acid; and isolating the intermediate grade migalastat hydrochloride from the aqueous migalastat hydrochloride solution; wherein the isolated intermediate grade migalastat hydrochloride contains 0.4% area or less of Compound U, 0.4% area or less of Compound V, 0.25% area or less of Compound Y, 0.15% area or less of Compound W, and 0.3% area or less of Compound BB.

In some embodiments, the batch of intermediate grade migalastat hydrochloride has 0.67% w/w or less of Compound U, 0.42% w/w or less of Compound V, 0.41% w/w or less of Compound Y, 0.15% w/w or less of Compound W, and 0.39% w/w or less of Compound BB, based on the weight of the intermediate grade migalastat hydrochloride. In some embodiments, the batch of intermediate grade migalastat hydrochloride contains 0.25% area or less of Compound Z and 0.15% area or less of Compound AA. In some embodiments, the batch of intermediate grade migalastat hydrochloride has 0.4% w/w or less of Compound Z and 0.41% w/w or less of Compound AA, based on the weight of the intermediate grade migalastat hydrochloride. In some embodiments, the batch of intermediate grade migalastat hydrochloride contains 1.0 μg or less of each of Compound Q and Compound P per gram of the isolated intermediate grade migalastat.

In some embodiments, the batch of intermediate grade migalastat hydrochloride contains 2.0 μg or less of Compound X per gram of the isolated intermediate grade migalastat.

In some embodiments, the batch of intermediate grade migalastat hydrochloride has one or more of: no detectable Compound U, 0.13% w/w or less of Compound V, 0.1% w/w or less of Compound Y, 0.04% w/w or less of Compound W, 0.15% w/w or less of Compound BB, 0.4% w/w or less of Compound Z, and 0.09% w/w or less of Compound AA, based on the weight of the intermediate grade migalastat hydrochloride.

In some embodiments, the intermediate grade migalastat hydrochloride has a residue on ignition of 7% w/w or less, based on the weight of the intermediate grade migalastat hydrochloride. In some embodiments, the intermediate grade migalastat hydrochloride has a residue on ignition of from 1.2% to 2.1% w/w, based on the weight of the intermediate grade migalastat hydrochloride.

In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed at a temperature of from 35° C.-55° C. In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed at a temperature of from 40° C.-50° C. In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed at a temperature of 45° C.

In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed with a palladium catalyst quantity of from 0.5 mol % to 2.5 mol %.

In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed with a palladium catalyst quantity of from 0.007-0.013 molar equivalents. In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed with a palladium catalyst quantity of 0.013 molar equivalents.

In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed in 6-10 volumes of methanol. In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed in 7-9 volumes of methanol. In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed in 9 volumes of methanol.

In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed at a hydrogen pressure of from 6-10 bar gauge (5-9 bar absolute). In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed at a hydrogen pressure of from 7-9 bar gauge (8-10 bar absolute). In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed at a hydrogen pressure of 8 bar gauge.

In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed for 44 hours or more. In some embodiments, the step of reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst is performed for 68 hours.

In some embodiments, the palladium catalyst is removed before adding the sodium methoxide.

In some embodiments, the step of treating the migalastat with hydrochloric acid comprises adding the hydrochloric acid to the migalastat to produce a migalastat/hydrochloric acid mixture, heating the migalastat/hydrochloric acid mixture for an age time to precipitate sodium chloride out of the mixture, cooling the mixture, and filtering out the sodium chloride.

In some embodiments, the filtering is at a filtration temperature of from 25° C. to 40° C.

In some embodiments, the hydrochloric acid has a concentration of from 35%-37% hydrochloric acid. In some embodiments, the hydrochloric acid has a concentration of 37% hydrochloric acid.

In some embodiments, the age time is from 1 to 10 hours.

In some embodiments, the heating is from 40° C. to 55° C.

In some embodiments, the step of adding sodium methoxide to the Compound S to produce migalastat further comprises adding methanol to the Compound S, wherein the method further comprises removing the methanol by distillation before adding the hydrochloric acid, and wherein the residual weight of the migalastat after distillation is 0.5-0.9 weights.

In some embodiments, the step of isolating the intermediate grade migalastat hydrochloride from the aqueous migalastat hydrochloride solution comprises treating the aqueous migalastat hydrochloride solution with charcoal and then crystallizing the intermediate grade migalastat hydrochloride with ethanol, wherein the ethanol is at a temperature of 15° C. or higher, and wherein the ethanol is added over a period of 12 minutes or more.

In some embodiments, the ethanol is at a temperature of from 15° C. to 25° C.

In some embodiments, the ethanol is added over a period of from 12 minutes to 50 minutes. In some embodiments, the ethanol is added over a period of 30 minutes or more.

Also provided are methods of determining the purity of a batch of intermediate grade migalastat hydrochloride produced from 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside, the method comprising performing a chromatographic test on the batch to determine that the batch has 0.4% w/w or less of Compound U, 0.4% w/w or less of Compound V, 0.25% w/w or less of Compound Y, 0.15% w/w or less of Compound W, and 0.3% w/w or less of Compound BB, based on the weight of the intermediate grade migalastat hydrochloride.

Some embodiments comprise determining that batch of intermediate grade migalastat hydrochloride has 0.25% w/w or less of Compound Z and 0.15% w/w or less of Compound AA, based on the weight of the intermediate grade migalastat hydrochloride.

Some embodiments comprise performing high performance liquid chromatography (HPLC) on the batch of intermediate grade migalastat hydrochloride to identify one or more of a first peak associated with the Compound U, a second peak associated with the Compound V, a third peak associated with the Compound Y, a fourth peak associated with the Compound W, a fifth peak associated with the Compound BB, a sixth peak associated with the Compound Z, and a seventh peak associated with the Compound AA, and determining that one or more of the area under the first peak is 0.4% or less of a total area under identified HPLC peaks, the area under the second peak is 0.4% or less of the total area under identified HPLC peaks, the area under the third peak is 0.25% or less of the total area under identified HPLC peaks, the area under the fourth peak is 0.15% or less of the total area under identified HPLC peaks, the area under the fifth peak is 0.3% or less of the total area under identified HPLC peaks, the area under the sixth peak is 0.25% or less of the total area under identified HPLC peaks, and the area under the seventh peak is 0.15% or less of the total area under identified HPLC peaks.

Also provided are methods for determining an amount of one or more of Compound U, Compound V, Compound Y, Compound W, Compound BB, Compound Z, and Compound AA in an intermediate grade migalastat hydrochloride sample, the method comprising one or more of: preparing Compound U by hydrogenating 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside and then treating it with sodium methoxide, and then using the prepared Compound U as a reference standard in a high performance liquid chromatography (HPLC) test conducted to determine the amount of Compound U in the intermediate grade migalastat hydrochloride sample; preparing Compound V by hydrogenation between migalastat hydrochloride and formaldehyde, and then using the prepared Compound V as a reference standard in an HPLC test conducted to determine the amount of Compound V in the intermediate grade migalastat hydrochloride sample; isolating Compound Y, from a filtrate obtained after recrystallizing a batch of intermediate grade migalastat hydrochloride, using hydrophilic interaction liquid chromatography, and then using the isolated Compound Y as a reference standard in an HPLC test conducted to determine the amount of Compound Y in the intermediate grade migalastat hydrochloride sample; preparing Compound W by hydrogenating migalastat hydrochloride in the presence of sodium methoxide and recrystallizing isolated crude, and then using the prepared Compound W as a reference standard in an HPLC test conducted to determine the amount of Compound W in the intermediate grade migalastat hydrochloride sample; isolating Compound BB, from a filtrate obtained after recrystallizing a batch of intermediate grade migalastat hydrochloride, using hydrophilic interaction liquid chromatography, and then using the isolated Compound BB as a reference standard in an HPLC test conducted to determine the amount of Compound BB in the intermediate grade migalastat hydrochloride sample; isolating Compound Z, from a filtrate obtained after recrystallizing a batch of intermediate grade migalastat hydrochloride, using hydrophilic interaction liquid chromatography, and then using the isolated Compound Z as a reference standard in an HPLC test conducted to determine the amount of Compound Z in the intermediate grade migalastat hydrochloride sample; and isolating Compound AA, from a filtrate obtained after recrystallizing a batch of intermediate grade migalastat hydrochloride, using hydrophilic interaction liquid chromatography, and then using the isolated Compound AA as a reference standard in an HPLC test conducted to determine the amount of Compound AA in the intermediate grade migalastat hydrochloride sample.

Also provided are methods of producing a batch of migalastat hydrochloride, the methods comprising: crystallizing intermediate grade migalastat hydrochloride twice in a mixture of water and ethanol to give migalastat hydrochloride, and isolating the batch of migalastat hydrochloride, wherein the batch of migalastat hydrochloride contains 0.15% w/w or less of Compound W, 0.15% w/w or less of Compound U, 0.15% w/w or less of Compound V, 0.15% w/w or less of Compound Y, 0.15% w/w or less of Compound BB, 0.3% w/w or less of methanol, 0.5% w/w or less of ethanol, 0.2% w/w or less of water, and 0.2% w/w or less of residue on ignition, each based on the weight of the migalastat hydrochloride, and 0.15 ppm or less of arsenic, 0.5 ppm or less of cadmium, 1.5 ppm or less of mercury, 0.5 ppm or less of lead, and 10 ppm or less of palladium.

Also provided are methods of determining the purity of a batch of migalastat hydrochloride, the methods comprising measuring an amount of Compound W, Compound U, Compound V, Compound Y, Compound BB, methanol, ethanol, water, residue on ignition, arsenic, cadmium, mercury, lead, and palladium in the batch of migalastat hydrochloride, wherein the batch of migalastat hydrochloride contains 0.15% w/w or less of Compound W, 0.15% w/w or less of Compound U, 0.15% w/w or less of Compound V, 0.15% w/w or less of Compound Y, 0.15% w/w or less of Compound BB, 0.3% w/w or less of methanol, 0.5% w/w or less of ethanol, 0.2% w/w or less of water, and 0.2% w/w or less of residue on ignition, each based on the weight of the migalastat hydrochloride, and 0.15 ppm or less of arsenic, 0.5 ppm or less of cadmium, 1.5 ppm or less of mercury, 0.5 ppm or less of lead, and 10 ppm or less of palladium.

In some embodiments, the batch of migalastat hydrochloride contains 0.10% w/w or less of any other particular impurity.

In some embodiments, the Compound W and Compound U are measured using high performance liquid chromatography (HPLC), and the Compound V, Compound Y, and Compound BB are measured using hydrophilic interaction liquid chromatography (HILIC), In some embodiments, total impurities measured using high performance liquid chromatography (HPLC) and hydrophilic interaction liquid chromatography (HILIC) are 0.5% w/w or less.

In some embodiments, the water is measured via Karl Fischer titration.

In some embodiments, the methanol and the ethanol are measured via gas chromatography.

In some embodiments, the arsenic, the cadmium, the mercury, the lead, and the palladium are measured via inductively coupled plasma mass spectroscopy.

In some embodiments, the migalastat hydrochloride is identified via (i) an infrared spectroscopy spectrum that is concordant with that of a migalastat hydrochloride reference material and (ii) a high performance liquid chromatography (HPLC) retention time that matches a migalastat hydrochloride reference standard.

In some embodiments, the migalastat hydrochloride contains 0.2% area or less of Compound CC, 1.4% area or less of Compound A, 0.6% area or less of Compound EE, and 4.1% area or less of Compound DD. In some embodiments, the migalastat hydrochloride has less than 0.1% w/w of each of Compound CC, Compound A, Compound EE, and Compound DD.

In some embodiments, each gram of the isolated migalastat hydrochloride contains less than 12 μg of each of Compound D, Compound F, 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside, Compound N, Compound Q, Compound P, Compound X, ethyl chloride, and methyl chloride.

In some embodiments, the batch of migalastat hydrochloride is produced with a first crystallization step that comprises: dissolving the intermediate grade migalastat hydrochloride in water at a first crystallization temperature to produce a first migalastat hydrochloride slurry; adding ethanol to the first migalastat hydrochloride slurry to induce a first crystallized migalastat hydrochloride; cooling the first migalastat hydrochloride slurry to a first isolation temperature to isolate the first crystallized migalastat hydrochloride; then filtering the first crystallized migalastat hydrochloride; washing the filtered first crystallized migalastat hydrochloride with ethanol; and drying the washed first crystallized migalastat hydrochloride.

Some embodiments comprise methods of producing the migalastat hydrochloride that comprise a second crystallization step that comprises: dissolving the dried first crystallized migalastat hydrochloride in water at a second crystallization temperature to produce a second migalastat hydrochloride slurry; adding a first portion of ethanol to the second migalastat hydrochloride slurry to induce a second crystallized migalastat hydrochloride; adding a second portion of ethanol to the second migalastat hydrochloride slurry after a hold time; then cooling the second migalastat hydrochloride slurry to a second isolation temperature to isolate the second crystallized migalastat hydrochloride; then filtering the second crystallized migalastat hydrochloride; washing the filtered second crystallized migalastat hydrochloride with ethanol; and drying the washed second crystallized migalastat hydrochloride to produce the batch of migalastat hydrochloride.

Also provided are methods of producing a batch of migalastat hydrochloride, the methods comprising dissolving intermediate grade migalastat hydrochloride in water at a first crystallization temperature to produce a first migalastat hydrochloride slurry; adding ethanol to the first migalastat hydrochloride slurry to induce a first crystallized migalastat hydrochloride; cooling the first migalastat hydrochloride slurry to a first isolation temperature to isolate the first crystallized migalastat hydrochloride; filtering the first crystallized migalastat hydrochloride; washing the filtered first crystallized migalastat hydrochloride with ethanol; drying the washed first crystallized migalastat hydrochloride; dissolving the dried first crystallized migalastat hydrochloride in water at a second crystallization temperature to produce a second migalastat hydrochloride slurry; adding a first portion of ethanol to the second migalastat hydrochloride slurry to induce a second crystallized migalastat hydrochloride; adding a second portion of ethanol to the second migalastat hydrochloride slurry after a hold time; cooling the second migalastat hydrochloride slurry to a second isolation temperature to isolate the second crystallized migalastat hydrochloride; filtering the second crystallized migalastat hydrochloride; washing the filtered second crystallized migalastat hydrochloride with ethanol; and drying the washed second crystallized migalastat hydrochloride to produce the batch of migalastat hydrochloride.

In some embodiments, the dissolving the intermediate grade migalastat hydrochloride and/or the dried first crystallized migalastat hydrochloride is in from 1.0-1.6 weights of water. In some embodiments, the dissolving the intermediate grade migalastat hydrochloride and/or the dried first crystallized migalastat hydrochloride is in from 1.1-1.4 weights of water. In some embodiments, the dissolving the intermediate grade migalastat hydrochloride and/or the dried first crystallized migalastat hydrochloride is in 1.3 weights of water.

In some embodiments, the first crystallization temperature and/or the second crystallization temperature is within a range of from 30° C. to 60° C. In some embodiments, the first crystallization temperature and/or the second crystallization temperature is within a range of from 40° C. to 60° C. In some embodiments, the first crystallization temperature and/or the second crystallization temperature is 50° C.

In some embodiments, the ethanol added to the first migalastat hydrochloride slurry and/or the combination of the first portion of ethanol and second portion of ethanol added to the second migalastat hydrochloride slurry is from 1-11.4 weights of ethanol. In some embodiments, the ethanol added to the first migalastat hydrochloride slurry and/or the combination of the first portion of ethanol and second portion of ethanol added to the second migalastat hydrochloride slurry is from 4.8-11.4 weights of ethanol. In some embodiments, the ethanol added to the first migalastat hydrochloride slurry and/or the combination of the first portion of ethanol and second portion of ethanol added to the second migalastat hydrochloride slurry is from 8.4-10.6 weights of ethanol. In some embodiments, the ethanol added to the first migalastat hydrochloride slurry and/or the combination of the first portion of ethanol and second portion of ethanol added to the second migalastat hydrochloride slurry is 9.5 weights of ethanol.

In some embodiments, the first isolation temperature and/or the second isolation temperature is within a range of from 5° C. to 35° C. In some embodiments, the first isolation temperature and/or the second isolation temperature is 20° C.

In some embodiments, the combination of the first portion of ethanol and the second portion of ethanol is from 1.0-11.4 weights of ethanol. In some embodiments, the first portion of ethanol comprises 1.8 to 2.0 weights of ethanol. In some embodiments, the first portion of ethanol is 1.9 weights of ethanol. In some embodiments, the second portion of ethanol comprises 6.7 to 8.4 weights of ethanol.

In some embodiments, the ethanol is added to the first migalastat hydrochloride slurry over a period of from 0 to 65 min. In some embodiments, the ethanol is added to the first migalastat hydrochloride slurry over a period of 60 min.

In some embodiments, the first portion of ethanol is added over a period of 5 min or more. In some embodiments, the first portion of ethanol is added over a period of from 5 min to 60 min.

In some embodiments, the hold time is 5 min or more. In some embodiments, the hold time is from 5 min to 60 min.

In some embodiments, the second portion of ethanol is added over a period of from 15 min to 60 min.

In some embodiments, the batch of migalastat hydrochloride comprises 0.6 kg or more of migalastat hydrochloride. In some embodiments, the batch of migalastat hydrochloride comprises 23 kg or more of migalastat hydrochloride.

Some embodiments comprise preparing the batch of migalastat hydrochloride, or a portion thereof, for commercial sale.

Some embodiments comprise packaging the batch of migalastat hydrochloride, or a portion thereof. Some embodiments comprise packing a portion of the migalastat hydrochloride in polyvinyl chloride (PVC)/polychlorotrifluoroethylene (PCTFE)/PVC laminate film with aluminum foil lidding blister packs.

Some embodiments comprise performing an integrity test on the packaged migalastat hydrochloride. In some embodiments, the integrity test comprises a water vapor permeation test.

Some embodiments comprise distributing the batch of migalastat hydrochloride, or a portion thereof.

Also provided are methods of distributing a commercial batch of migalastat hydrochloride, the methods comprising: (i) producing a batch of migalastat hydrochloride; (ii) validating the batch of migalastat hydrochloride by determining that the batch contains 0.15% w/w or less of Compound W, 0.15% w/w or less of Compound U, 0.15% w/w or less of Compound V, 0.15% w/w or less of Compound Y, 0.15% w/w or less of Compound BB, 0.3% w/w or less of methanol, 0.5% w/w or less of ethanol, 0.2% w/w or less of water, and 0.2% w/w or less of residue on ignition, each based on the weight of the migalastat hydrochloride, and 0.15 ppm or less of arsenic, 0.5 ppm or less of cadmium, 1.5 ppm or less of mercury, 0.5 ppm or less of lead, and 10 ppm or less of palladium; and (iii) distributing the validated commercial batch, or a portion thereof, for medical use in a human subject.

Some embodiments comprise tracking the distributed migalastat hydrochloride, or a portion thereof. In some embodiments, the tracking comprises scanning a barcode associated with the migalastat hydrochloride, or a portion thereof. In some embodiments, the barcode encodes information that includes one or more of a name of a product, a strength and dosage form of the product, a NDC number of the product, a container size, a number of containers, a lot number of the product, a date of a transaction, a date of the shipment, and a business name and address of a person from whom and to whom ownership of the migalastat hydrochloride, or portion thereof, is being transferred.

Some embodiments comprise storing the migalastat hydrochloride, or a portion thereof, at a storage temperature of from 20° C. to 25° C.

Also provided are methods of assessing the suitability of migalastat hydrochloride for medical use in a human subject, the methods comprising: (i) performing high performance liquid chromatography (HPLC) on the migalastat hydrochloride to determine that the migalastat hydrochloride contains 0.15% w/w or less of Compound W and 0.15% w/w or less of Compound U; (ii) performing hydrophilic interaction liquid chromatography (HILIC) on the migalastat hydrochloride to determine that the migalastat hydrochloride contains 0.15% w/w or less of Compound V, 0.15% w/w or less of Compound Y, and 0.15% w/w or less of Compound BB; (iii) performing a Karl Fischer titration on the migalastat hydrochloride to determine that the migalastat hydrochloride contains 0.2% w/w or less of water; (iv) performing gas chromatography on the migalastat hydrochloride to determine that the migalastat hydrochloride contains 0.3% w/w or less of methanol and 0.5% w/w or less of ethanol; and (v) performing inductively coupled plasma mass spectroscopy on the migalastat hydrochloride to determine that the migalastat hydrochloride contains 0.15 ppm or less of arsenic, 0.5 ppm or less of cadmium, 1.5 ppm or less of mercury, 0.5 ppm or less of lead, and 10 ppm or less of palladium, wherein the migalastat hydrochloride is suitable for medical use in a human subject.

Also provided are compositions comprising batches produced or obtainable by any of the above methods. In some embodiments, the composition comprises a batch of 1,2,3,6-tetrapivaloyl-D-galactofuranoside. In some embodiments, the composition comprises a batch of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside. In some embodiments, the composition comprises a batch of intermediate grade migalastat hydrochloride. In some embodiments, the composition comprises a batch of migalastat hydrochloride. In some embodiments, the composition comprises a batch of pharmaceutical grade migalastat hydrochloride.

Also provided are methods of treating a subject having Fabry disease by administering migalastat produced or obtainable by any of the above methods.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 sets forth a diagram showing an exemplary migalastat hydrochloride synthesis scheme.

FIG. 2 depicts Stage 1 of an exemplary migalastat hydrochloride synthesis scheme, and shows an impurity that can result from Stage 1.

FIG. 3 depicts Stage 2 of an exemplary migalastat hydrochloride synthesis scheme.

FIG. 4 also depicts Stage 2 of an exemplary migalastat hydrochloride synthesis scheme, and shows impurities that can result from Stage 2.

FIG. 5 depicts Stage 3 of an exemplary migalastat hydrochloride synthesis scheme.

FIG. 6 also depicts Stage 3 of an exemplary migalastat hydrochloride synthesis scheme, and shows impurities that can result from Stage 3.

FIG. 7 depicts Stages 3a and 3b of an exemplary migalastat hydrochloride synthesis scheme.

FIG. 8 depicts Stages 3a and 3b of an exemplary migalastat hydrochloride synthesis scheme.

FIG. 9 depicts formation of impurities during Stage 3 of an exemplary migalastat hydrochloride synthesis scheme.

FIG. 10 shows a half-normal effects plot identifying the effects of individual parameters and interactions between parameters on critical quality attributes.

FIG. 11 shows an effects plot illustrating the effect of palladium catalyst quantity on levels of Compound V.

FIG. 12 shows a half-normal effects plot showing how experimental parameters influence Compound U formation.

FIG. 13 shows an interaction plot showing the impact of temperature and palladium catalyst quantity on Compound U formation.

FIG. 14 shows a reaction profile for Stage 3a at various production scales.

FIG. 15 depicts Stages 3b and 3c of an exemplary migalastat hydrochloride synthesis scheme.

FIG. 16 shows a schematic of an exemplary Stage 3b process in which temperature is varied after addition of hydrochloric acid.

FIG. 17 shows a half normal plot showing the impact of filtration temperature on residue on ignition in intermediate grade migalastat hydrochloride.

FIG. 18 provides a graphical representation of solubility data associated with sodium chloride across a range of temperatures in a reaction mixture of hydrochloric acid and methanol.

FIG. 19 depicts Stages 3b and 3c of an exemplary migalastat hydrochloride synthesis scheme.

FIG. 20 shows a half normal plot showing the impact of various production parameters on the levels of Compound X.

FIG. 21 depicts a process for purging Compound X during Stages 3b and 3c of an exemplary migalastat hydrochloride synthesis scheme.

FIG. 22 shows a half-normal plot showing the impact of ethanol addition time and temperature during Stage 3c on levels of Compound U.

FIG. 23 shows an effects plot illustrating the impact of temperature on levels of Compound U.

FIG. 24 depicts Stage 4 of an exemplary migalastat hydrochloride synthesis scheme, and shows impurities that can result from Stage 4.

FIG. 25 provides graphical representation of the impact of total quantities of water (left graph) and ethanol (right graph) on the relative concentration of sodium chloride solubilized in a crystallization mixture.

FIG. 26 depicts a flow diagram showing exemplary process controls that can be used for commercial production of migalastat hydrochloride.

DETAILED DESCRIPTION

Technical and scientific terms used herein have the meanings commonly understood by one of ordinary skill in the art to which the present invention pertains, unless otherwise defined. Materials to which reference is made in the following description and examples are obtainable from commercial sources, unless otherwise noted.

As used herein, the singular forms “a,” “an,” and “the” designate both the singular and the plural, unless expressly stated to designate the singular only.

It is noted that in this disclosure and particularly in the claims and/or paragraphs, terms such as “comprises,” “comprising,” “consists of,” “consisting of,” “consists essentially of,” and “consisting essentially of” can have the meaning attributed to it in U.S. patent law. It is contemplated that features set forth using any of such terms can instead be set forth using another of such terms. For instance, if a feature is set forth using “comprising” language, alternative embodiments setting forth the feature using “consisting of” or “consisting essentially of” language is within the scope of the present disclosure.

The term “about” means that the number comprehended is not limited to the exact number set forth herein, and is intended to refer to numbers substantially around the recited number while not departing from the scope of the invention. As used herein, “about” will be understood by persons of ordinary skill in the art and will vary to some extent on the context in which it is used. In the context of numerical values, “about” will mean up to plus or minus 10% of the particular numerical value unless otherwise noted. As used herein, “approximately” in the context of a numerical value or range means +/−5% of the numerical value. It is contemplated that disclosed numerical values can be modified to include ranges that are about or approximately the numerical value.

“Intermediate grade” as used herein means that a substance does not comply with regulatory requirements for a finished pharmaceutical product, e.g., because it does not meet specification criteria for one or more of drug identity, strength, quality, and purity.

“Pharmaceutical grade” as used herein means that a substance (e.g., an active pharmaceutical ingredient) complies with regulatory requirements (e.g., FDA, EMA, and/or PMDA requirements) for incorporation into a finished drug product, e.g., related to identity, strength, quality, and purity.

A “critical quality attribute” (CQA) is a physical, chemical, biological, or microbiological property or characteristic that should be within an appropriate limit, range, or distribution to ensure the desired product quality. CQAs of solid oral dosage forms are typically those aspects affecting product purity, strength, drug release, and/or stability. For drug substances, raw materials, and intermediates, the CQAs can additionally include those properties (e.g., particle size distribution, bulk density) that affect drug product CQAs.

A “critical process parameter” (CPP) is process parameter whose variability has an impact on a critical quality attribute.

The term “Fabry disease” refers to an X-linked inborn error of glycosphingolipid catabolism due to deficient lysosomal α-Gal A activity. This defect causes accumulation of the substrate globotriaosylceramide (“GL-3”, also known as Gb₃ or ceramide trihexoside) and related glycosphingolipids in vascular endothelial lysosomes of the heart, kidneys, skin, and/or other tissues. Another substrate of the enzyme is plasma globotriaosylsphingosine (“plasma lyso-Gb₃”).

A “carrier” is a female who has one X chromosome with a defective α-Gal A gene and one X chromosome with the normal gene and in whom X chromosome inactivation of the normal allele is present in one or more cell types. A carrier can be diagnosed with Fabry disease.

A “patient” refers to a subject who has been diagnosed with or is suspected of having a particular disease. The patient may be human or animal.

A “Fabry patient” refers to an individual who has been diagnosed with or suspected of having Fabry disease and has a mutated α-Gal A as defined further below. Characteristic markers of Fabry disease can occur in male hemizygotes and female carriers with the same prevalence, although females typically are less severely affected.

The term “ERT-naive patient” refers to a Fabry patient that has never received enzyme replacement therapy (ERT) or has not received ERT for at least 6 months prior to initiating migalastat therapy.

The term “ERT-experienced patient” refers to a Fabry patient that was receiving ERT immediately prior to initiating migalastat therapy. In some embodiments, the ERT-experienced patient has received at least 12 months of ERT immediately prior to initiating migalastat therapy.

Human α-galactosidase A (α-Gal A) refers to an enzyme encoded by the human GLA gene. The full DNA sequence of α-Gal A, including introns and exons, is available in GenBank Accession No. X14448.1. The human α-Gal A enzyme consists of 429 amino acids and is available in GenBank Accession Nos. X14448.1 and U78027.1.

The term “mutant protein” includes a protein which has a mutation in the gene encoding the protein which results in the inability of the protein to achieve a stable conformation under the conditions normally present in the endoplasmic reticulum (ER). The failure to achieve a stable conformation results in a substantial amount of the enzyme being degraded, rather than being transported to the lysosome. Such a mutation is sometimes called a “conformational mutant.” Such mutations include, but are not limited to, missense mutations, and in-frame small deletions and insertions.

The term “mutant α-Gal A” includes an α-Gal A which has a mutation in the gene encoding α-Gal A which results in the inability of the enzyme to achieve a stable conformation under the conditions normally present in the ER. The failure to achieve a stable conformation results in a substantial amount of the enzyme being degraded, rather than being transported to the lysosome.

“Deficient α-Gal A activity” refers to α-Gal A activity in cells from a patient which is below the normal range as compared (using the same methods) to the activity in cells from normal individuals not having Fabry.

The term “α-Gal A activity” refers to the normal physiological function of a wild-type α-Gal A in a cell. For example, α-Gal A activity includes hydrolysis of GL-3.

The terms “enhance α-Gal A activity” or “increase α-Gal A activity” refer to increasing the amount of α-Gal A that adopts a stable conformation in a cell contacted with a pharmacological chaperone specific for the α-Gal A, relative to the amount in a cell (preferably of the same cell-type or the same cell, e.g., at an earlier time) not contacted with the pharmacological chaperone specific for the α-Gal A. This term also refers to increasing the trafficking of α-Gal A to the lysosome in a cell contacted with a pharmacological chaperone specific for the α-Gal A, relative to the trafficking of α-Gal A not contacted with the pharmacological chaperone specific for the protein. These terms refer to both wild-type and mutant α-Gal A. In one embodiment, the increase in the amount of α-Gal A in the cell is measured by measuring the hydrolysis of an artificial substrate in lysates from cells that have been treated with the PC. An increase in hydrolysis is indicative of increased α-Gal A activity.

A “responder” is an individual diagnosed with or suspected of having a lysosomal storage disorder, such as Fabry disease, whose cells exhibit sufficiently increased α-Gal A activity, respectively, and/or amelioration of symptoms or enhancement in surrogate markers, in response to contact with a pharmaceutical chaperone. Non-limiting examples of enhancements in surrogate markers for Fabry are lyso-Gb₃ and those disclosed in U.S. Patent Application Publication No. US 2010/0113517, which is hereby incorporated by reference in its entirety.

“Weights” is referred to as a relative amount of a component or compound, and it is defined relative to a reference material. For instance, for 1 g of a reference material, 2 weights of a compound means 2 g of the compound. Other relative amounts, such as “molar equivalents” and “volumes” are also determined with reference to a reference material.

The production of migalastat hydrochloride can result in a plurality of impurities, especially when produced at a large scale (bulk) quantity. Provided are methods of producing migalastat hydrochloride with controlled levels of impurities. Also provided are methods of producing intermediates used in the production of migalastat hydrochloride. Also provided are methods useful for validating, releasing, and or distributing a batch of migalastat hydrochloride, or a portion thereof. The methods are also useful for validating, releasing, and or distributing a batch of an intermediate of migalastat hydrochloride, or a portion thereof.

Migalastat

Migalastat, also known as 1-deoxygalactonojirimycin (DGJ) or (2R,3S,4R,5S)-2-(hydroxymethyl) piperdine-3,4,5-triol, refers to a compound having the following free base structures:

The term migalastat generally encompasses both the free base form and any pharmaceutically acceptable salt forms, such as migalastat hydrochloride. Migalastat hydrochloride is a compound having the following structure:

As used herein, the term “free base equivalent” or “FBE” refers to the amount of DGJ present in the DGJ or salt thereof. In other words, the term “FBE” means either an amount of DGJ free base, or the equivalent amount of DGJ free base that is provided by a salt of DGJ. For example, due to the weight of the chloride anion, 150 mg of DGJ HCl provides as much DGJ as 123 mg of the free base form of DGJ. Other salts will have different conversion factors, depending on the molecular weight of the counter ion. While migalastat hydrochloride is referenced throughout, also provided are methods and compositions that instead use other salts, such as hydrobromide, nitrate, perchlorate, phosphate, sulphate, formate, acetate, aconate, ascorbate, benzenesulphonate, benzoate, cinnamate, citrate, embonate, enantate, fumarate, glutamate, glycolate, lactate, maleate, malonate, mandelate, methane-sulphonate, naphthalene-2-sulphonate, phthalate, salicylate, sorbate, stearate, succinate, tartrate, toluene-p-sulphonate, and the like.

The term migalastat hydrochloride encompasses pharmaceutical grade migalastat hydrochloride, intermediate grade migalastat hydrochloride, and pre-intermediate grade migalastat hydrochloride (e.g., in aqueous solution). However, unless specifically noted to refer to intermediate grade migalastat hydrochloride, or unless it would be apparent to the person skilled in the art to refer to intermediate grade migalastat hydrochloride or pre-intermediate grade migalastat hydrochloride based on context, the term migalastat hydrochloride will implicate a degree of purity sufficient for pharmaceutical use.

Migalastat hydrochloride generally has a white to almost white appearance and is in solid form.

Migalastat hydrochloride can be produced in four general stages, each of which are discussed below. Compounds formed throughout Stages 1-3 of the process can be considered to be intermediates of pharmaceutical grade migalastat hydrochloride. The stage 4 process can produce pharmaceutical grade drug substance.

Stage 1: Preparation of 1,2,3,6-tetrapivaloyl-D-galactofuranoside

Stage 1 of migalastat hydrochloride production can be performed by reacting pivaloyl imidazole with D-(+)-galactose to give 1,2,3,6-tetrapivaloyl-D-galactofuranoside. To the extent amounts of Stage 1 components are described using relative terms (e.g., weights or molar equivalents), those amounts are relative to D-(+)-galactose unless indicated otherwise.

In some embodiments, D-(+)-galactose is dissolved by heating in N,N-Dimethylformamide (DMF). In some embodiments, the D-(+)-galactose is dissolved in at least about 12 weights (expressed relative to D-(+)-galactose) of DMF, such as about 12 weights to about 18 weights, about 12.10 to about 17.08 weights, about 12 weights, about 13 weights, about 14 weights, about 15 weights, about 16 weights, or about 17 weights of DMF. In some embodiments, the D-(+)-galactose is dissolved in at least 12 weights of DMF, such as 12 weights to 18 weights, 12.10 to 17.08 weights, 12 weights, 13 weights, 14 weights, 15 weights, 16 weights, or 17 weights of DMF.

In some embodiments, the galactose is dissolved in DMF at a temperature of from about 80° C. to about 100° C., about 85° C. to about 90° C., about 88° C. to about 92° C., about 88° C., about 89° C., about 90° C., about 91° C., or about 92° C. In some embodiments, the galactose is dissolved in DMF at a temperature of from 80° C. to 100° C., 85° C. to 90° C., 88° C. to 92° C., 88° C., 89° C., 90° C., 91° C., or 92° C.

In some embodiments, a solution of pivaloyl imidazole in toluene is added to the solution of D-(+)-galactose, and then the mixture is treated with methanol. In some embodiments, the solution of pivaloyl imidazole contains about 15 to about 35% w/w pivaloyl imidazole, about 18 to about 30% w/w, about 18.4 to about 28.3% w/w, about 19% w/w, about 20% w/w, about 21% w/w, about 22% w/w, about 23% w/w, about 24% w/w, about 25% w/w, about 26% w/w, about 27% w/w, or about 28% w/w pivaloyl imidazole, based on the total weight of the solution. In some embodiments, the solution of pivaloyl imidazole contains 15 to 35% w/w pivaloyl imidazole, 18 to 30% w/w, 18.4 to 28.3% w/w, 19% w/w, 20% w/w, 21% w/w, 22% w/w, 23% w/w, 24% w/w, 25% w/w, 26% w/w, 27% w/w, or 28% w/w pivaloyl imidazole, based on the total weight of the solution.

In some embodiments, about 3.5 to about 5.5 molar equivalents of pivaloyl imidazole is added to the solution of D-(+)-galactose, such as about 4 to about 5 molar equivalents, about 4.5 to about 5 molar equivalents, about 4.6 to about 4.8 molar equivalents, about 4.6 molar equivalents, about 4.7 molar equivalents, or about 4.8 molar equivalents of pivaloyl imidazole. In some embodiments, 3.5 to 5.5 molar equivalents of pivaloyl imidazole is added to the solution of D-(+)-galactose, such as 4 to 5 molar equivalents, 4.5 to 5 molar equivalents, 4.6 to 4.8 molar equivalents, 4.6 molar equivalents, 4.7 molar equivalents, or 4.8 molar equivalents of pivaloyl imidazole.

In some embodiments, the pivaloyl imidazole is reacted with the D-(+)-galactose at a temperature of from about 70° C. to about 90° C., such as from about 75° C. to about 85° C., about 77° C. to about 85° C., about 77° C., about 78° C., about 79° C., about 80° C., about 81° C., about 82° C., about 83° C., about 84° C., or about 85° C. In some embodiments, the pivaloyl imidazole is reacted with the D-(+)-galactose at a temperature of from 70° C. to 90° C., such as from 75° C. to 85° C., 77° C. to 85° C., 77° C., 78° C., 79° C., 80° C., 81° C., 82° C., 83° C., 84° C., or 85° C.

In some embodiments, the mixture of pivaloyl imidazole and D-(+)-galactose is treated with methanol. In some embodiments, the mixture is treated with from about 0.25 to about 5 weights of methanol, such as about 0.5 to about 4 weights, about 0.5 to about 3 weights, about 0.5 weights, about 1 weight, about 2 weights, or about 3 weights of methanol. In some embodiments, the mixture is treated with from 0.25 to 5 weights of methanol, such as 0.5 to 4 weights, 0.5 to 3 weights, 0.5 weights, 1 weight, 2 weights, or 3 weights of methanol.

In some embodiments, the resultant mixture is washed with water and the organic layer is separated. In some embodiments, the solution is concentrated and heptane is added and then the mixture is seeded and cooled. In some embodiments, about 5 to about 10 weights of heptane is added, such as about 6 to about 9.5 weights, about 6.27 to about 9.4 weights, about 6.27 weights, about 7 weights, about 8 weights, about 9 weights, or about 9.4 weights of heptane is added. In some embodiments, 5 to 10 weights of heptane are added, such as 6 to 9.5 weights, 6.27 to 9.4 weights, 6.27 weights, 7 weights, 8 weights, 9 weights, or 9.4 weights of heptane.

In some embodiments, the solution is crystallized at a temperature of from about −60° to about −5° C., such as about −55° C. to about −10° C., about −50° C. to about −15° C., about −50° C., about −45° C., about −40° C., about −35° C., about −30° C., about −25° C., about −20° C., or about −15° C. In some embodiments, the solution is crystallized at a temperature of from −60° to −5° C., such as −55° C. to −10° C., −50° C. to −15° C., −50° C., −45° C., −40° C., −35° C., −30° C., −25° C., −20° C., or −15° C.

In some embodiments, the yield of 1,2,3,6-tetrapivaloyl-D-galactofuranoside is about 15% or more, such as about 20% or more, about 23% or more, about 25% or more, about 30% or more, about 33% or more, about 15% to about 40%, about 20% to about 35%, about 23% to about 33%, about 23%, about 25%, about 30%, or about 33%. In some embodiments, the yield of 1,2,3,6-tetrapivaloyl-D-galactofuranoside is 15% or more, such as 20% or more, 23% or more, 25% or more, 30% or more, 33% or more, 15% to 40%, 20% to 35%, 23% to 33%, 23%, 25%, 30%, or 33%.

1,2,3,6-tetrapivaloyl-D-galactofuranoside Purity

Purity of 1,2,3,6-tetrapivaloyl-D-galactofuranoside can be expressed using an amount of total or specific impurities. Amounts can be calculated, inter alia, using % w/w (e.g., based on the weight of the 1,2,3,6-tetrapivaloyl-D-galactofuranoside) or % area (e.g., based on the area under a chromatograph peak, such as an HPLC peak, of the impurity or impurities as compared to the total area under chromatographic peaks). A particularly disclosed impurity percentage is meant to encompass amounts as calculated based on % w/w and/or % area. In other words: in some embodiments, the % impurity is calculated based on % w/w; in some embodiments the % impurity is calculated based on % area; in some embodiments the % impurity is calculated based on % w/w and % area.

In some embodiments, the produced 1,2,3,6-tetrapivaloyl-D-galactofuranoside has about 5% or less of total impurities, such as about 4% or less, about 3% or less, about 2.9% or less, about 2% or less, about 1% or less, or about 1.5% to about 2.5% of total impurities. In some embodiments, the produced 1,2,3,6-tetrapivaloyl-D-galactofuranoside has 5% or less total impurities, such as 4% or less, 3% or less, 2.9% or less, 2% or less, 1% or less, or 1.5% to 2.5% of total impurities. In some embodiments, the produced 1,2,3,6-tetrapivaloyl-D-galactofuranoside has about 5% or less of Compound B, such as about 4% or less, about 3% or less, about 2.9% or less, about 2% or less, about 1% or less, or about 1.5% to about 2.5% of Compound B. In some embodiments, the produced 1,2,3,6-tetrapivaloyl-D-galactofuranoside has 5% or less of Compound B, such as 4% or less, 3% or less, 2.9% or less, 2% or less, 1% or less, or 1.5% to 2.5% of Compound B.

Stage 2: Preparation of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside

Stage 2 of migalastat hydrochloride production can be performed by activating 1,2,3,6-tetrapivaloyl-D-galactofuranoside with trifluoromethanesulfonic acid anhydride and then reacting it with water to give 1,2,3,6-tetrapivaloyl-α-L-altrofuranoside. The resulting intermediate can be activated with trifluoromethanesulfonic acid anhydride and then reacted with sodium azide to give 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside. To the extent amounts of Stage 2 components are described using relative terms (e.g., weights or molar equivalents), those amounts are relative to 1,2,3,6-tetrapivaloyl-D-galactofuranoside unless indicated otherwise.

In some embodiments, the trifluoromethanesulfonic acid anhydride in either of the above-mentioned steps is independently from about 0.5 to about 3 molar equivalents, such as from about 0.75 to about 2 molar equivalents, about 1 to about 1.6 molar equivalents, about 1 molar equivalent, about 1.5 molar equivalents, or about 1.6 molar equivalents. In some embodiments, the trifluoromethanesulfonic acid anhydride in either of the above-mentioned steps is independently from 0.5 to 3 molar equivalents, such as from 0.75 to 2 molar equivalents, 1 to 1.6 molar equivalents, 1 molar equivalent, 1.5 molar equivalents, or 1.6 molar equivalents.

Some embodiments comprise adding trifluoromethanesulfonic acid anhydride and pyridine to a solution of 1,2,3,6-tetrapivaloyl-D-galactofuranoside in isopropyl acetate (IPAc). In some embodiments, about 0.75 to about 3 weights of pyridine is added to the solution, such as about 1 weight to about 2 weights, about 1.15 weights to about 1.73 weights, about 1.15 weights, about 1.25 weights, about 1.5 weights, or about 1.73 weights. In some embodiments, 0.75 to 3 weights of pyridine are added to the solution, such as 1 weight to 2 weights, 1.15 weights to 1.73 weights, 1.15 weights, 1.25 weights, 1.5 weights, or 1.73 weights of pyridine.

In some embodiments, water is added to the mixture of trifluoromethanesulfonic acid anhydride, pyridine, 1,2,3,6-tetrapivaloyl-D-galactofuranoside, and IPAc. In some embodiments, the mixture is then heated, e.g., to a temperature of from about 45° C. to about 70° C., such as from about 50° C. to about 65° C., about 55° C. to about 60° C., about 55° C., about 56° C., about 57° C., about 58° C., about 59° C., or about 60° C. In some embodiments, the mixture is heated to a temperature of from 45° C. to 70° C., such as from 50° C. to 65° C., 55° C. to 60° C., 55° C., 56° C., 57° C., 58° C., 59° C., or 60° C.

In some embodiments, the aqueous layer is separated and the organic layer is dried by azeotropic distillation before adding IPAc and then 1,8-diazabicycloundec-7-ene (DBU) to produce Compound E. Some embodiments comprise adding from about 0.02 to about 0.08 weights of DBU, such as from about 0.03 to about 0.07, from about 0.033 to about 0.066, about 0.033, about 0.04, about 0.05, about 0.06, or about 0.066 weights of DBU. Some embodiments comprise adding from 0.02 to 0.08 weights of DBU, such as from 0.03 to 0.07, from 0.033 to 0.066, 0.033, 0.04, 0.05, 0.06, or 0.066 weights of DBU.

Some embodiments comprise washing the IPAc solution of Compound E with aqueous hydrochloric acid (HCl) and then with aqueous pyridine. In some embodiments, the aqueous pyridine comprises about 0.75 to about 3 weights of pyridine, such as about 1 weight to about 2 weights, about 1.15 weights to about 1.73 weights, about 1.15 weights, about 1.25 weights, about 1.5 weights, or about 1.73 weights of pyridine. In some embodiments, 0.75 to 3 weights of pyridine are added to the solution, such as 1 weight to 2 weights, 1.15 weights to 1.73 weights, 1.15 weights, 1.25 weights, 1.5 weights, or 1.73 weights of pyridine.

In some embodiments, the resulting solution is dried by azeotropic distillation and diluted with IPAc addition. In some embodiments, trifluoromethanesulfonic acid anhydride and pyridine are added (e.g., at amounts previously mentioned) to the distilled and diluted solution.

In some embodiments, an IPAc solution of Compound F is washed with water and added to sodium azide and N,N-diisopropylethylamine (DIPEA) in dimethylsulfoxide (DMSO). Some embodiments comprise adding the solution to about 0.05 to about 0.3 weights of sodium azide, such as from about 0.1 to about 0.2, about 0.13 to about 0.19, about 0.13, about 0.15, about 0.17, or about 0.19 weights of sodium azide. Some embodiments comprise adding the solution to 0.05 to 0.3 weights of sodium azide, such as from 0.1 to 0.2, 0.13 to 0.19, 0.13, 0.15, 0.17, or 0.19 weights of sodium azide. Some embodiments comprise adding the solution to about 0.1 to about 0.7 weights of DIPEA, such as about 0.2 to about 0.6 weights, about 0.25 to about 0.5 weights, about 0.28 to about 0.4 weights, about 0.28 weights, about 0.35 weights, or about 0.4 weights of DIPEA. Some embodiments comprise adding the solution to 0.1 to 0.7 weights of DIPEA, such as 0.2 to 0.6 weights, 0.25 to 0.5 weights, 0.28 to 0.4 weights, 0.28 weights, 0.35 weights, or 0.4 weights of DIPEA.

Some embodiments comprise stirring the mixture of Compound F, sodium azide, and DIPEA. In some embodiments, the mixture is stirred for at least about 30 minutes, at least about 45 minutes, or at least about 1 hour. In some embodiments, the mixture is stirred for at least 30 minutes, at least 45 minutes, or at least 1 hour.

In some embodiments, a 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside mixture is washed with water and the organic layer is concentrated by distillation. In some embodiments, the concentrated mixture is treated with ethanol and water. In some embodiments, the concentrated mixture is treated with from about 3 to about 12 weights of ethanol, such as from about 4 to about 11 weights, about 5 to about 10 weights, about 5.5 to about 9 weights, about 5.64 to about 8.45 weights, about 5.64 weights, about 6 weights, about 7 weights, about 8 weights, or about 8.45 weights of ethanol. In some embodiments, the concentrated mixture is treated with from 3 to 12 weights of ethanol, such as from 4 to 11 weights, 5 to 10 weights, 5.5 to 9 weights, 5.64 to 8.45 weights, 5.64 weights, 6 weights, 7 weights, 8 weights, or 8.45 weights of ethanol. In some embodiments, the concentrated mixture is treated with from about 2 to about 11 weights of water, such as from about 3 to about 10 weights, about 4 to about 9 weights, about 4.5 to about 8 weights, about 4.78 to about 7.17 weights, about 4.78 weights, about 5 weights, about 6 weights, about 7 weights, or about 7.17 weights of water. In some embodiments, the concentrated mixture is treated with from 2 to 11 weights of water, such as from 3 to 10 weights, 4 to 9 weights, 4.5 to 8 weights, 4.78 to 7.17 weights, 4.78 weights, 5 weights, 6 weights, 7 weights, or 7.17 weights of water.

In some embodiments, solid 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is isolated by filtration. In some embodiments, the filtration is at a temperature of from about 5° C. to about 35° C., such as from about 10° C. to about 30° C., about 10° C. to about 25° C., about 10° C., about 15° C., about 20° C., or about 25° C. In some embodiments, the filtration is at a temperature of from 5° C. to 35° C., such as from 10° C. to 30° C., 10° C. to 25° C., 10° C., 15° C., 20° C., or 25° C.

Some embodiments comprise washing solid 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside in methanol. In some embodiments, the solid 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is washed in from about 0.5 to about 4 weights of methanol, such as from about 0.6 to about 3 weights, about 0.7 to about 2.5 weights, about 0.79 to about 2.38 weights, about 0.79 weights, about 1 weight, about 1.5 weights, about 2 weights, or about 2.38 weights of methanol. In some embodiments, the solid 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is washed in from 0.5 to 4 weights of methanol, such as from 0.6 to 3 weights, 0.7 to 2.5 weights, 0.79 to 2.38 weights, 0.79 weights, 1 weight, 1.5 weights, 2 weights, or 2.38 weights of methanol.

Some embodiments comprise drying the washed 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside. In some embodiments, the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is dried under vacuum. In some embodiments, the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is dried under vacuum with heating. In some embodiments, the heating is at about 50° C. or less, such as about 45° C. or less, or about 40° C. or less. In some embodiments, the heating is at 50° C. or less, such as 45° C. or less, or 40° C. or less.

In some embodiments, the yield of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is about 45% or more, such as about 50% or more, about 53% or more, about 55% or more, about 60% or more, about 65% or more, about 73% or more, about 75% or more, about 50% to about 75%, about 53% to about 73%, about 53%, about 60%, about 65%, or about 73%. In some embodiments, the yield of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is 45% or more, such as 50% or more, 53% or more, 55% or more, 60% or more, 65% or more, 73% or more, 75% or more, 50% to 75%, 53% to 73%, 53%, 60%, 65%, or 73%.

5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside Purity

Purity of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside can be expressed using an amount of total or specific impurities. Amounts can be calculated, inter alia, using % w/w (e.g., based on the weight of the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside) or % area (e.g., based on the area under a chromatograph peak, such as an HPLC peak, of the impurity or impurities as compared to the total area under chromatographic peaks). A particularly disclosed impurity percentage is meant to encompass amounts as calculated based on % w/w and/or % area. In other words: in some embodiments, the % impurity is calculated based on % w/w; in some embodiments the % impurity is calculated based on % area; in some embodiments the % impurity is calculated based on % w/w and % area.

In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has about 4% or less of 1,2,3,6-tetrapivaloyl-D-galactofuranoside, such as about 3% or less, about 2.6% or less, about 2% or less, about 1.5% or less, about 1% or less, about 0.75% or less, about 0.6% or less, about 0.5% or less, about 0.36% or less, about 0.25% or less, about 0.16% or less, about 0.1% or less, or about 0.16 to about 0.36% of 1,2,3,6-tetrapivaloyl-D-galactofuranoside. In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has 4% or less of 1,2,3,6-tetrapivaloyl-D-galactofuranoside, such as 3% or less, 2.6% or less, 2% or less, 1.5% or less, 1% or less, 0.75% or less, 0.6% or less, 0.5% or less, 0.36% or less, 0.25% or less, 0.16% or less, 0.1% or less, or 0.16 to 0.36% of 1,2,3,6-tetrapivaloyl-D-galactofuranoside.

In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has about 3% or less of Compound E, such as about 2% or less, about 1.5% or less, about 1.3% or less, about 1% or less, about 0.75% or less, about 0.5% or less, about 0.3% or less, about 0.1% or less, about 0.06% or less, or about 0.05% or less. In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has 3% or less of Compound E, such as 2% or less, 1.5% or less, 1.3% or less, 1% or less, 0.75% or less, 0.5% or less, 0.3% or less, 0.1% or less, 0.06% or less, or 0.05% or less. In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has no detectable amount of Compound E.

In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has about 3% or less of Compound G, such as about 2% or less, about 1.5% or less, about 1.3% or less, about 1% or less, about 0.75% or less, about 0.5% or less, about 0.3% or less, about 0.1% or less, about 0.06% or less, about 0.05% or less, or about 0.03% or less. In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has 3% or less of Compound G, such as 2% or less, 1.5% or less, 1.3% or less, 1% or less, 0.75% or less, 0.5% or less, 0.3% or less, 0.1% or less, 0.06% or less, 0.05% or less, or 0.03% or less. In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has no detectable amount of Compound G.

In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has about 7% or less of Compound J, such as about 6% or less, about 5% or less, about 4% or less, about 3% or less, about 2% or less, about 1% or less, about 0.5% or less, or about 0.86% to about 1.67% of Compound J. In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has 7% or less of Compound J, such as 6% or less, 5% or less, 4% or less, 3% or less, 2% or less, 1% or less, 0.5% or less, or 0.86% to 1.67% of Compound J.

In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has about 3% or less of Compound I, such as about 2% or less, about 1.5% or less, about 1.3% or less, about 1% or less, about 0.9% or less, about 0.75% or less, about 0.6% or less, about 0.5% or less, about 0.35% or less, about 0.3% or less, about 0.1% or less, about 0.06% or less, about 0.05% or less, or about 0.03% or less. In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has 3% or less of Compound I, such as 2% or less, 1.5% or less, 1.3% or less, 1% or less, 0.9% or less, 0.75% or less, 0.6% or less, 0.5% or less, 0.35% or less, 0.3% or less, 0.1% or less, 0.06% or less, 0.05% or less, or 0.03% or less. In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has no detectable amount of Compound I.

In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has about 3% or less of Compound K, such as about 2% or less, about 1.5% or less, about 1.3% or less, about 1% or less, about 0.9% or less, about 0.75% or less, about 0.6% or less, about 0.5% or less, about 0.35% or less, about 0.3% or less, about 0.11% or less, about 0.1% or less, about 0.08% or less, about 0.06% or less, about 0.05% or less, about 0.03% or less, or about 0.08% to about 0.11% of Compound K. In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has 3% or less of Compound K, such as 2% or less, 1.5% or less, 1.3% or less, 1% or less, 0.9% or less, 0.75% or less, 0.6% or less, 0.5% or less, 0.35% or less, 0.3% or less, 0.11% or less, 0.1% or less, 0.08% or less, 0.06% or less, 0.05% or less, 0.03% or less, or 0.08% to 0.11% of Compound K.

In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has about 3% or less of Compound N, such as about 2% or less, about 1.5% or less, about 1% or less, about 0.75% or less, about 0.6% or less, about 0.5% or less, about 0.28% or less, about 0.25% or less, about 0.2% or less, about 0.1% or less, about 0.06% or less, or about 0.06% to about 0.28% of Compound N. In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has 3% or less of Compound N, such as 2% or less, 1.5% or less, 1% or less, 0.75% or less, 0.6% or less, 0.5% or less, 0.28% or less, 0.25% or less, 0.2% or less, 0.1% or less, 0.06% or less, or 0.06% to about 0.28% of Compound N.

In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has about 3% or less of Compound 0, such as about 2% or less, about 1.5% or less, about 1% or less, about 0.75% or less, about 0.6% or less, about 0.5% or less, about 0.3% or less, about 0.17% or less, about 0.12% or less, about 0.1% or less, about 0.05% or less, or about 0.12% to about 0.17% of Compound O. In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has 3% or less of Compound 0, such as 2% or less, 1.5% or less, 1% or less, 0.75% or less, 0.6% or less, 0.5% or less, 0.3% or less, 0.17% or less, 0.12% or less, 0.1% or less, 0.05% or less, or 0.12% to 0.17% of Compound O.

In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has about 5% or less of total impurities, such as about 4% or less, about 3% or less, about 2.9% or less, about 2% or less, about 1% or less, or about 1.5% to about 2.5% of total impurities. In some embodiments, the produced 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside has 5% or less total impurities, such as 4% or less, 3% or less, 2.9% or less, 2% or less, 1% or less, or 1.5% to 2.5% of total impurities.

Stage 3: Preparation of Intermediate Grade Migalastat Hydrochloride

Stage 3 of migalastat hydrochloride production can be performed by reducing 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside using hydrogen and a palladium catalyst. In some embodiments, following a rearrangement and further hydrogenation, sodium methoxide is added to remove pivaloyl groups. In some embodiments, the product is treated with hydrochloric acid and isolated to give intermediate grade migalastat hydrochloride. Stage 3 of migalastat hydrochloride production can be separated into 3 sub-steps, termed Stages 3a, 3b, and 3c. To the extent amounts of Stage 3 components are described using relative terms (e.g., weights, molar equivalents, or volumes), those amounts are relative to 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside unless indicated otherwise.

Stage 3a

In some embodiments, 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside and a palladium catalyst on carbon are stirred in methanol under a hydrogen atmosphere. In some embodiments, the palladium catalyst is a 10% palladium catalyst on carbon. Some embodiments comprise using about 0.005 to about 0.05 molar equivalents of the palladium catalyst, such as about 0.006 to about 0.04 molar equivalents, about 0.007 to about 0.03 molar equivalents, about 0.007 to about 0.02 molar equivalents, about 0.007 to about 0.013 molar equivalents, about 0.007 molar equivalents, about 0.008 molar equivalents, about 0.009 molar equivalents, about 0.01 molar equivalents, about 0.011 molar equivalents, about 0.012 molar equivalents, or about 0.013 molar equivalents of palladium catalyst. Some embodiments comprise using 0.005 to 0.05 molar equivalents of the palladium catalyst, such as 0.006 to 0.04 molar equivalents, 0.007 to 0.03 molar equivalents, 0.007 to 0.02 molar equivalents, 0.007 to 0.013 molar equivalents, 0.007 molar equivalents, 0.008 molar equivalents, 0.009 molar equivalents, 0.01 molar equivalents, 0.011 molar equivalents, 0.012 molar equivalents, or 0.013 molar equivalents of palladium catalyst.

In some embodiments, the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside and a palladium catalyst on carbon are stirred in about 3 to about 9 weights of methanol, such as about 4 to about 8 weights, about 5 to about 7.5 weights, about 5.54 to about 7.13 weights, about 5.54 weights, about 6 weights, about 6.5 weights, about 7 weights, or about 7.13 weights of methanol. In some embodiments, the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside and a palladium catalyst on carbon are stirred in 3 to 9 weights of methanol, such as 4 to 8 weights, 5 to 7.5 weights, 5.54 to 7.13 weights, 5.54 weights, 6 weights, 6.5 weights, 7 weights, or 7.13 weights of methanol.

In some embodiments, the process of stirring the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside and the palladium catalyst on carbon in methanol under a hydrogen atmosphere is vented several times (e.g., 2, 3, 4, 5, 6, 7, 8, 9, or 10 or more times) to release nitrogen, and hydrogen pressure is reapplied each time. In some embodiments the mixture is stirred (e.g., after venting) at a temperature of from about 30° C. to about 60° C., such as from about 35° C. to about 55° C., about 40° C. to about 50° C., about 40° C., about 45° C., or about 50° C. In some embodiments the mixture is stirred at a temperature of from 30° C. to 60° C., such as from 35° C. to 55° C., 40° C. to 50° C., 40° C., 45° C., or 50° C.

In some embodiments, the hydrogen pressure is from about 5 bar (absolute) to about 13 bar (absolute), such as from about 6 bar to about 12 bar, about 7 bar to about 11 bar, about 8 bar to about 10 bar, about 8 bar, about 9 bar, or about 10 bar. In some embodiments, the hydrogen pressure is from 5 bar (absolute) to 13 bar (absolute), such as from 6 bar to 12 bar, 7 bar to 11 bar, 8 bar to 10 bar, 8 bar, 9 bar, or 10 bar.

In some embodiments, the stirring is for a time period of about 30 minutes or more, such as about 35 minutes or more, about 40 minutes or more, about 44 minutes or more, about 50 minutes or more, about 55 minutes or more, about 60 minutes or more, about 65 minutes or more, about 68 minutes or more, about 75 minutes or more, about 30 minutes to about 80 minutes, about 35 minutes to about 75 minutes, about 40 minutes to about 70 minutes, about 44 minutes to about 68 minutes, about 44 minutes, about 45 minutes, about 50 minutes, about 55 minutes, about 60 minutes, about 65 minutes, or about 68 minutes. In some embodiments, the stirring is for a time period of 30 minutes or more, such as 35 minutes or more, 40 minutes or more, 44 minutes or more, 50 minutes or more, 55 minutes or more, 60 minutes or more, 65 minutes or more, 68 minutes or more, 75 minutes or more, 30 minutes to 80 minutes, 35 minutes to 75 minutes, 40 minutes to 70 minutes, 44 minutes to 68 minutes, 44 minutes, 45 minutes, 50 minutes, 55 minutes, 60 minutes, 65 minutes, or 68 minutes.

Stage 3b

In some embodiments, a sodium methoxide solution (e.g., 30% sodium methoxide) in methanol is added to a solution of Compound S. In some embodiments, the sodium methoxide solution contains from about 0.5 to about 2 equivalents of methanol, such as from about 0.7 to about 1.5 equivalents, about 0.8 to about 1.2 equivalents, about 0.8 equivalents, about 0.9 equivalents, about 1 equivalent, about 1.1 equivalents, or about 1.2 equivalents of methanol. In some embodiments, the sodium methoxide solution contains from 0.5 to 2 equivalents of methanol, such as from 0.7 to 1.5 equivalents, 0.8 to 1.2 equivalents, 0.8 equivalents, 0.9 equivalents, 1 equivalent, 1.1 equivalents, or 1.2 equivalents of methanol.

In some embodiments, the sodium methoxide/Compound S mixture is concentrated, e.g., by distillation. In some embodiments, the mixture is concentrated to about 0.3 weights, about 0.4 weights, about 0.5 weights, about 0.6 weights, about 0.7 weights, or about 0.8 weights (by volume marker). In some embodiments, the mixture is concentrated to 0.3 weights, 0.4 weights, 0.5 weights, 0.6 weights, 0.7 weights, or 0.8 weights (by volume marker). In some embodiments, hydrochloric acid is added to the concentrated mixture. In some embodiments, the hydrochloride acid is at a concentration of from about 30% to about 45% hydrochloric acid, such as from about 33% to about 40%, about 35% to about 37%, about 35%, about 36%, or about 37% hydrochloric acid. In some embodiments, the hydrochloride acid is at a concentration of from 30% to 45% hydrochloric acid, such as from 33% to 40%, 35% to 37%, 35%, 36%, or 37% hydrochloric acid.

In some embodiments, about 1.5 to about 4 volumes of hydrochloric acid is added to the mixture, such as from about 2 to about 3.5 volumes, about 2.9 to about 3.2 volumes, about 2.9 volumes, about 3 volumes, about 3.1 volumes, or about 3.2 volumes. In some embodiments, 1.5 to 4 volumes of hydrochloric acid are added to the mixture, such as from 2 to 3.5 volumes, 2.9 to 3.2 volumes, 2.9 volumes, 3 volumes, 3.1 volumes, or 3.2 volumes. Without being bound by theory, it is believed that hydrochloric acid can function as an antisolvent for the by-product sodium chloride (e.g., which precipitates out after adding sodium chloride and agitating a batch), which can then be removed by filtration.

In some embodiments, the hydrochloric acid is added at a temperature of from about 10° C. to about 60° C., such as from about 15° C. to about 55° C., about 20° C. to about 50° C., about 20° C. to about 45° C., about 20° C., about 25° C., about 30° C., about 35° C., about 40° C., or about 45° C. In some embodiments, the hydrochloric acid is added at a temperature of from 10° C. to 60° C., such as from 15° C. to 55° C., 20° C. to 50° C., 20° C. to 45° C., 20° C., 25° C., 30° C., 35° C., 40° C., or 45° C.

In some embodiments, the mixture is aged for an age time following addition of the hydrochloric acid to allow precipitation of sodium chloride. In some embodiments, the age time is about 15 hours or less, such as about 12 hours or less, about 10 hours or less, about 9 hours or less, about 8 hours or less, about 7 hours or less, about 6 hours of less, or about 5 hours or less. In some embodiments, the age time is 15 hours or less, such as 12 hours or less, 10 hours or less, 9 hours or less, 8 hours or less, 7 hours or less, 6 hours of less, or 5 hours or less.

In some embodiments, the mixture is aged at a temperature of from about 25° C. to about 70° C., such as from about 30° C. to about 65° C., about 35° C. to about 60° C., about 40° C. to about 55° C., about 40° C., about 45° C., about 50° C., or about 55° C. In some embodiments, the mixture is aged at a temperature of from 25° C. to 70° C., such as from 30° C. to 65° C., 35° C. to 60° C., 40° C. to 55° C., 40° C., 45° C., 50° C., or 55° C.

In some embodiments, the suspension formed from aging the mixture is cooled to a filtration temperature and then the sodium chloride is filtered. In some embodiments, the filtration temperature is from about 15° C. to about 50° C., such as from about 20° C. to about 45° C., about 25° C. to about 40° C., about 25° C., about 30° C., about 35° C., or about 40° C. In some embodiments, the filtration temperature is from 15° C. to 50° C., such as from 20° C. to 45° C., 25° C. to 40° C., 25° C., 30° C., 35° C., or 40° C.

Stage 3c

In some embodiments, ethanol is added to the product of Stage 3b. In some embodiments, the ethanol is added over a period of about 15 minutes or more, such as about 20 minutes or more, about 25 minutes or more, about 30 minutes or more, about 35 minutes or more, about 40 minutes or more, about 45 minutes or more, about 50 minutes or more, about 55 minutes or more, about 60 minutes or more, about 20 minutes, about 25 minutes, about 30 minutes, about 35 minutes, about 40 minutes, about 45 minutes, about 50 minutes, about 55 minutes, or about 60 minutes. In some embodiments, the ethanol is added over a period of 15 minutes or more, such as 20 minutes or more, 25 minutes or more, 30 minutes or more, 35 minutes or more, 40 minutes or more, 45 minutes or more, 50 minutes or more, 55 minutes or more, 60 minutes or more, 20 minutes, 25 minutes, 30 minutes, 35 minutes, 40 minutes, 45 minutes, 50 minutes, 55 minutes, or 60 minutes.

In some embodiments, intermediate grade migalastat hydrochloride is isolated. In some embodiments, the intermediate grade migalastat hydrochloride is isolated at a temperature of about 5° C. or more, such as about 10° C. or more, about 15° C. or more, about 20° C. or more, about 25° C. or more, about 30° C. or more, about 5° C., about 10° C., about 15° C., about 20° C., about 25° C., or about 30° C. In some embodiments, the intermediate grade migalastat hydrochloride is isolated at a temperature of 5° C. or more, such as 10° C. or more, 15° C. or more, 20° C. or more, 25° C. or more, 30° C. or more, 5° C., 10° C., 15° C., 20° C., 25° C., or 30° C.

In some embodiments, the isolated intermediate grade migalastat hydrochloride is washed, e.g., with ethanol. In some embodiments, the washed intermediate grade migalastat hydrochloride is dried.

In some embodiments, the yield of intermediate grade migalastat hydrochloride is about 50% or more, such as about 60% or more, about 65% or more, about 70% or more, about 72% or more, about 75% or more, about 80% or more, about 85% or more, about 90% or more, about 92% or more, about 95% or more, about 70% to about 95%, or about 72% to about 92%. In some embodiments, the yield of intermediate grade migalastat hydrochloride is 50% or more, such as 60% or more, 65% or more, 70% or more, 72% or more, 75% or more, 80% or more, 85% or more, 90% or more, 92% or more, 95% or more, 70% to 95%, or 72% to 92%.

Intermediate Grade Migalastat Purity

Purity of intermediate grade migalastat can be expressed using an amount of total or specific impurities. Amounts can be calculated, inter alia, using % w/w (e.g., based on the weight of the intermediate grade migalastat) or % area (e.g., based on the area under a chromatograph peak, such as an HPLC peak, of the impurity or impurities as compared to the total area under chromatographic peaks). A particularly disclosed impurity percentage is meant to encompass amounts as calculated based on % w/w and/or % area. In other words: in some embodiments, the % impurity is calculated based on % w/w; in some embodiments the % impurity is calculated based on % area; in some embodiments the % impurity is calculated based on % w/w and % area. If an impurity amount is specifically tied to a type of calculation (e.g., % w/w), it is understood that such a calculation is not limiting on the scope of the disclosure, and so the impurity amount additionally or alternatively can be determined using other calculations (e.g., % area) if desired.

In some embodiments, the produced intermediate grade migalastat has about 2% w/w or less of Compound U, such as about 1% w/w or less, about 0.75% w/w or less, about 0.67% w/w or less, about 0.5% w/w or less, about 0.4% w/w or less, about 0.25% w/w or less, or about 0.1% w/w or less of Compound U. In some embodiments, the produced intermediate grade migalastat has 2% w/w or less of Compound U, such as 1% w/w or less, 0.75% w/w or less, 0.67% w/w or less, 0.5% w/w or less, 0.4% w/w or less, 0.25% w/w or less, or 0.1% w/w or less of Compound U. In some embodiments, the intermediate grade migalastat hydrochloride has no detectable amount of Compound U.

In some embodiments, the produced intermediate grade migalastat has about 2% w/w or less of Compound V, such as about 1% w/w or less, about 0.75% w/w or less, about 0.5% w/w or less, about 0.42% w/w or less, about 0.4% w/w or less, about 0.25% w/w or less, about 0.13% w/w or less, or about 0.1% w/w or less of Compound V. In some embodiments, the produced intermediate grade migalastat has 2% w/w or less of Compound V, such as 1% w/w or less, 0.75% w/w or less, 0.5% w/w or less, 0.42% w/w or less, 0.4% w/w or less, 0.25% w/w or less, 0.13% w/w or less, or 0.1% w/w or less of Compound V. In some embodiments, the intermediate grade migalastat hydrochloride has no detectable amount of Compound V.

In some embodiments, the produced intermediate grade migalastat has about 2% w/w or less of Compound Y, such as about 1% w/w or less, about 0.75% w/w or less, about 0.5% w/w or less, about 0.41% w/w or less, about 0.4% w/w or less, about 0.25% w/w or less, or about 0.1% w/w or less of Compound Y. In some embodiments, the produced intermediate grade migalastat has 2% w/w or less of Compound Y, such as 1% w/w or less, 0.75% w/w or less, 0.5% w/w or less, 0.41% w/w or less, 0.4% w/w or less, 0.25% w/w or less, or 0.1% w/w or less of Compound Y. In some embodiments, the intermediate grade migalastat hydrochloride has no detectable amount of Compound Y.

In some embodiments, the produced intermediate grade migalastat has about 2% w/w or less of Compound W, such as about 1% w/w or less, about 0.75% w/w or less, about 0.5% w/w or less, about 0.25% w/w or less, about 0.15% or less, about 0.1% w/w or less, about 0.04% or less, or about 0.01% or less of Compound W. In some embodiments, the produced intermediate grade migalastat has 2% w/w or less of Compound W, such as 1% w/w or less, 0.75% w/w or less, 0.5% w/w or less, 0.25% w/w or less, 0.15% or less, 0.1% w/w or less, 0.04% or less, or 0.01% or less of Compound W. In some embodiments, the intermediate grade migalastat hydrochloride has no detectable amount of Compound W.

In some embodiments, the produced intermediate grade migalastat has about 2% w/w or less of Compound BB, such as about 1% w/w or less, about 0.75% w/w or less, about 0.5% w/w or less, about 0.4% w/w or less, about 0.39% w/w or less, about 0.3% or less, about 0.25% w/w or less, about 0.15% or less, or about 0.1% w/w or less of Compound BB. In some embodiments, the produced intermediate grade migalastat has 2% w/w or less of Compound BB, such as 1% w/w or less, 0.75% w/w or less, 0.5% w/w or less, 0.4% w/w or less, 0.39% w/w or less, 0.3% or less, 0.25% w/w or less, 0.15% or less, or 0.1% w/w or less of Compound BB. In some embodiments, the intermediate grade migalastat hydrochloride has no detectable amount of Compound BB.

In some embodiments, the produced intermediate grade migalastat has about 2% w/w or less of Compound Z, such as about 1% w/w or less, about 0.75% w/w or less, about 0.5% w/w or less, about 0.44% w/w or less, about 0.4% w/w or less, about 0.25% w/w or less, about 0.15% or less, or about 0.1% w/w or less of Compound Z. In some embodiments, the produced intermediate grade migalastat has 2% w/w or less of Compound Z, such as 1% w/w or less, 0.75% w/w or less, 0.5% w/w or less, 0.44% w/w or less, 0.4% w/w or less, 0.25% w/w or less, 0.15% or less, or 0.1% w/w or less of Compound Z. In some embodiments, the intermediate grade migalastat hydrochloride has no detectable amount of Compound Z.

In some embodiments, the produced intermediate grade migalastat has about 2% w/w or less of Compound AA, such as about 1% w/w or less, about 0.75% w/w or less, about 0.5% w/w or less, about 0.41% w/w or less, about 0.4% w/w or less, about 0.25% w/w or less, about 0.15% or less, about 0.1% w/w or less, about 0.09% or less, or about 0.05% or less of Compound AA. In some embodiments, the produced intermediate grade migalastat has 2% w/w or less of Compound AA, such as 1% w/w or less, 0.75% w/w or less, 0.5% w/w or less, 0.41% w/w or less, 0.4% w/w or less, 0.25% w/w or less, 0.15% or less, 0.1% w/w or less, 0.09% or less, or 0.05% or less of Compound AA. In some embodiments, the intermediate grade migalastat hydrochloride has no detectable amount of Compound AA.

In some embodiments, the intermediate grade migalastat hydrochloride contains about 1.2% area or less of Compound CC, such as about 1% or less, about 0.7% or less, about 0.5% or less, about 0.2% or less, or about 0.1% or less of Compound CC. In some embodiments, the intermediate grade migalastat hydrochloride contains 1.2% area or less of Compound CC, such as 1% or less, 0.7% or less, 0.5% or less, 0.2% or less, or 0.1% or less of Compound CC.

In some embodiments, the intermediate grade migalastat hydrochloride contains about 1.4% area or less of Compound A, such as about 1.2% or less, about 1% or less, about 0.7% or less, about 0.5% or less, about 0.2% or less, or about 0.1% or less of Compound A. In some embodiments, the intermediate grade migalastat hydrochloride contains 1.4% area or less of Compound A, such as 1.2% or less, 1% or less, 0.7% or less, 0.5% or less, 0.2% or less, or 0.1% or less of Compound A.

In some embodiments, the intermediate grade migalastat hydrochloride contains about 0.6% area or less of Compound EE, such as about 0.5% or less, about 0.4% or less, about 0.3% or less, about 0.2% or less, or about 0.1% or less of Compound EE. In some embodiments, the intermediate grade migalastat hydrochloride contains 0.6% area or less of Compound EE, such as 0.5% or less, 0.4% or less, 0.3% or less, 0.2% or less, or 0.1% or less of Compound EE.

In some embodiments, the intermediate grade migalastat hydrochloride contains about 4.1% area or less of Compound DD, such as about 3% or less, about 2% or less, about 1% or less, about 0.7% or less, about 0.5% or less, about 0.2% or less, or about 0.1% or less of Compound DD. In some embodiments, the intermediate grade migalastat hydrochloride contains 4.1% area or less of Compound DD, such as 3% or less, 2% or less, 1% or less, 0.7% or less, 0.5% or less, 0.2% or less, or 0.1% or less of Compound DD.

In some embodiments, the intermediate grade migalastat hydrochloride has about 5% or less of total impurities, such as about 4% or less, about 3% or less, about 2% or less, about 1.5% or less, about 1% or less, about 0.67% or less, about 0.61% or less, about 0.5% or less, about 0.32% or less, about 0.31% or less, or about 0.25% or less of total impurities. In some embodiments, the intermediate grade migalastat hydrochloride has 5% or less of total impurities, such as 4% or less, 3% or less, 2% or less, 1.5% or less, 1% or less, 0.67% or less, 0.61% or less, 0.5% or less, 0.32% or less, 0.31% or less, or 0.25% or less of total impurities.

Stage 4: Preparation of Pharmaceutical Grade Migalastat Hydrochloride

In some embodiments, intermediate grade migalastat hydrochloride is crystallized to form pharmaceutical grade migalastat hydrochloride. In some embodiments intermediate grade migalastat hydrochloride is crystallized twice or more (e.g., two times, three times, four times, or more) to form pharmaceutical grade migalastat hydrochloride.

Stage 4a: First Crystallization Step

To the extent amounts of Stage 4a components are described using relative terms (e.g., weights), those amounts are relative to intermediate grade migalastat unless indicated otherwise

In some embodiments, the crystallization is in a mixture of water and ethanol. In some embodiments, the intermediate grade migalastat hydrochloride is dissolved in water. In some embodiments, the intermediate grade migalastat hydrochloride is dissolved in from about 0.5 to about 4 weights of water, such as from about 0.5 to about 3 weights, about 1 to about 2 weights, about 1.1 to about 1.4 weights, about 1.1 weights, about 1.2 weights, about 1.3 weights, or about 1.4 weights of water. In some embodiments, the intermediate grade migalastat hydrochloride is dissolved in from 0.5 to 4 weights of water, such as from 0.5 to 3 weights, 1 to 2 weights, 1.1 to about 1.4, 1.1 weights, 1.2 weights, 1.3 weights, or 1.4 weights of water.

In some embodiments, the temperature is adjusted after the intermediate grade migalastat hydrochloride is dissolved in water, e.g., to a temperature of from about 30° C. to about 70° C., about 35° C. to about 65° C., about 40° C. to about 60° C., about 40° C., about 45° C., about 50° C., about 55° C., or about 60° C. In some embodiments, the temperature is adjusted after the intermediate grade migalastat hydrochloride is dissolved in water, e.g., to a temperature of from 30° C. to 70° C., 35° C. to 65° C., 40° C. to 60° C., 40° C., 45° C., 50° C., 55° C., or 60° C.

In some embodiments, ethanol is added to the dissolved intermediate grade migalastat to form a slurry. In some embodiments, from about 6 to about 15 weights of ethanol is added, such as from about 7 to about 12 weights, about 8 to about 11 weights, about 8.5 to about 10.4 weights, about 8.5 weights, about 9 weights, about 9.5 weights, about 10 weights, or about 10.4 weights of ethanol. In some embodiments, from 6 to 15 weights of ethanol is added, such as from 7 to 12 weights, 8 to 11 weights, 8.5 to 10.4 weights, 8.5 weights, 9 weights, 9.5 weights, 10 weights, or 10.4 weights of ethanol.

In some embodiments, the slurry is cooled to an isolation temperature, e.g., of from about 3° C. to about 50° C., about 5° C. to about 45° C., about 5° C. to about 40° C., about 5° C. to about 35° C., about 5° C., about 10° C., about 15° C., about 20° C., about 25° C., about 30° C., or about 35° C. In some embodiments, the isolation temperature is from 3° C. to 50° C., 5° C. to 45° C., 5° C. to 40° C., 5° C. to 35° C., 5° C., 10° C., 15° C., 20° C., 25° C., 30° C., or 35° C.

In some embodiments, Stage 4a product is isolated from the slurry via filtration (e.g., conducted at the isolation temperature). In some embodiments, the isolated Stage 4a product is washed, e.g., with ethanol. The ethanol wash can be conducted with about 0.5 weights of ethanol (relative to the weight of the isolated Stage 4a product) or more, such as about 1 or more weights, about 2 or more weights, about 3 or more weights, about 5 or more weights, or about 10 or more weights. In some embodiments, the ethanol wash is conducted with 0.5 weights of ethanol or more, such as 1 or more weights, 2 or more weights, 3 or more weights, 5 or more weights, or 10 or more weights.

In some embodiments, the Stage 4a product is dried, e.g., under vacuum. In some embodiments, the Stage 4a product is dried at a temperature or about 90° C. or less, such as about 80° C. or less, about 70° C. or less, about 60° C. or less, about 50° C. or less, about 80° C., about 70° C., or about 60° C. In some embodiments, Stage 4a product is dried at a temperature or 90° C. or less, such as 80° C. or less, 70° C. or less, 60° C. or less, 50° C. or less, 80° C., 70° C., or 60° C.

Stage 4b: Second Crystallization Step

To the extent amounts Stage 4b components are described using relative terms (e.g., weights), those amounts are relative to the Stage 4a product unless indicated otherwise

In some embodiments, the Stage 4a product is clarified by filtration. In some embodiments, the Stage 4a product (e.g., the clarified product) dissolved in water. In some embodiments, the Stage 4a product is dissolved in from about 0.5 to about 4 weights of water, such as from about 0.5 to about 3 weights, about 1 to about 2 weights, about 1.1 to about 1.4 weights, about 1.1 weights, about 1.2 weights, about 1.3 weights, or about 1.4 weights of water.

In some embodiments, the Stage 4a product is dissolved in from 0.5 to 4 weights of water, such as from 0.5 to 3 weights, 1 to 2 weights, 1.1 to about 1.4, 1.1 weights, 1.2 weights, 1.3 weights, or 1.4 weights of water.

In some embodiments, the temperature is adjusted after the Stage 4a product is dissolved in water, e.g., to a temperature of from about 30° C. to about 70° C., about 35° C. to about 65° C., about 40° C. to about 60° C., about 40° C., about 45° C., about 50° C., about 55° C., or about 60° C. In some embodiments, the temperature is adjusted after the Stage 4a product is dissolved in water, e.g., to a temperature of from 30° C. to 70° C., 35° C. to 65° C., 40° C. to 60° C., 40° C., 45° C., 50° C., 55° C., or 60° C.

In some embodiments, a first quantity of ethanol is added to the dissolved Stage 4a product to induce crystallization. In some embodiments, the first quantity of ethanol is from about 0.5 to about 4 weights of ethanol, such as from about 0.75 to about 3 weights, about 1 to about 2.5 weights, about 1.8 to about 2 weights, about 1.8 weights, about 1.9 weights, or about 2 weights of ethanol. In some embodiments, the first quantity of ethanol is from 0.5 to 4 weights of ethanol, such as from 0.75 to 3 weights, 1 to 2.5 weights, 1.8 to 2 weights, 1.8 weights, 1.9 weights, or 2 weights of ethanol.

In some embodiments, the first quantity of ethanol is added over a period of about 3 minutes or more, such as about 4 minutes or more, about 5 minutes or more, about 10 minutes or more, or about 15 minutes or more. In some embodiments, the first quantity of ethanol is added over a period of 3 minutes or more, such as 4 minutes or more, 5 minutes or more, 10 minutes or more, or 15 minutes or more.

In some embodiments, a second quantity of ethanol is added to the mixture following a hold time. The hold time can be about 3 minutes or more, such as about 4 minutes or more, about 5 minutes or more, about 10 minutes or more, or about 15 minutes or more. In some embodiments, the hold time is a period of 3 minutes or more, such as 4 minutes or more, 5 minutes or more, 10 minutes or more, or 15 minutes or more.

In some embodiments, the second quantity of ethanol comprises about 4 to about 15 weights of ethanol, such as from about 5 to about 12 weights, about 6 to about 10 weights, about 6.5 to about 9 weights, about 6.8 to about 8.4 weights, about 6.8 weights, about 7 weights, about 7.5 weights, about 8 weights, or about 8.4 weights of ethanol. In some embodiments, the second quantity of ethanol comprises 4 to 15 weights of ethanol, such as from 5 to 12 weights, 6 to 10 weights, 6.5 to 9 weights, 6.8 to 8.4 weights, 6.8 weights, 7 weights, 7.5 weights, 8 weights, or 8.4 weights of ethanol.

In some embodiments, the second quantity of ethanol is added over a period of about 10 minutes or more, such as about 15 minutes or more, about 20 minutes or more, about 30 minutes or more, about 45 minutes or more, or about 60 minutes or more. In some embodiments, the second quantity of ethanol is added over a period of 10 minutes or more, such as 15 minutes or more, 20 minutes or more, 30 minutes or more, 45 minutes or more, or 60 minutes or more.

In some embodiments, the amount of ethanol used in Stage 4b (i.e., the first quantity of ethanol+the second quantity of ethanol) is the same as the amount of ethanol used in Stage 4a. In some embodiments, the amount of ethanol used in Stage 4b is different from the amount of ethanol used in Stage 4a.

Some embodiments comprise cooling the Stage 4b slurry (e.g., that contains both the first and second quantities of ethanol) to an isolation temperature. In some embodiments, the slurry is cooled to an isolation temperature, e.g., of from about 3° C. to about 50° C., about 5° C. to about 45° C., about 5° C. to about 40° C., about 5° C. to about 35° C., about 5° C., about 10° C., about 15° C., about 20° C., about 25° C., about 30° C., or about 35° C. In some embodiments, the isolation temperature is 3° C. to 50° C., 5° C. to 45° C., 5° C. to 40° C., 5° C. to 35° C., 5° C., 10° C., 15° C., 20° C., 25° C., 30° C., or 35° C.

In some embodiments, Stage 4b product is isolated from the slurry via filtration (e.g., conducted at the isolation temperature). In some embodiments, the isolated Stage 4b product is washed, e.g., with ethanol. The ethanol wash can be conducted with about 0.5 weights of ethanol or more, such as about 1 or more weight, about 2 or more weights, about 3 or more weights, about 5 or more weights, or about 10 or more weights of ethanol. In some embodiments, the ethanol wash is conducted with 0.5 weights of ethanol or more, such as 1 or more weight, 2 or more weights, 3 or more weights, 5 or more weights, or 10 or more weights of ethanol.

In some embodiments, the Stage 4b product is dried, e.g., under vacuum. In some embodiments, the Stage 4b product is dried at a temperature of about 90° C. or less, such as about 80° C. or less, about 70° C. or less, about 60° C. or less, about 50° C. or less, about 80° C., about 70° C., or about 60° C. In some embodiments, Stage 4b product is dried at a temperature of 90° C. or less, such as 80° C. or less, 70° C. or less, 60° C. or less, 50° C. or less, 80° C., 70° C., or 60° C.

In some embodiments, the yield of pharmaceutical grade migalastat hydrochloride is about 40% or more, such as about 50% or more, about 56% or more, about 60% or more, about 65% or more, about 70% or more, about 80% or more, about 85% or more, about 90% or more, about 95% or more, about 100% or more, about 102% or more, about 50% to about 105%, or about 56% to about 102%. In some embodiments, the yield of pharmaceutical grade migalastat hydrochloride is 40% or more, such as 50% or more, 56% or more, 60% or more, 65% or more, 70% or more, 80% or more, 85% or more, 90% or more, 95% or more, 100% or more, 102% or more, 50% to 105%, or 56% to 102%.

Pharmaceutical Grade Migalastat Purity

Purity of pharmaceutical grade migalastat can be expressed using an amount of total or specific impurities. Amounts can be calculated, inter alia, using % w/w (e.g., based on the weight of the pharmaceutical grade migalastat hydrochloride), % area (e.g., based on the area under a chromatograph peak, such as an HPLC peak, of the impurity or impurities as compared to the pharmaceutical grade migalastat hydrochloride), parts per million (ppm), etc. A particularly disclosed impurity percentage is meant to encompass amounts as calculated based on % w/w and/or % area. In other words: in some embodiments, the % impurity is calculated based on % w/w; in some embodiments the % impurity is calculated based on % area; in some embodiments the % impurity is calculated based on % w/w and % area. If an impurity amount is specifically tied to a type of calculation (e.g., % w/w), it is understood that such a calculation is not limiting on the scope of the disclosure, and so the impurity amount additionally or alternatively can be determined using other calculations (e.g., % area) if desired.

In some embodiments, the produced pharmaceutical grade migalastat has about 0.15% w/w or less of Compound W, such as about 0.1% w/w or less, about 0.05 w/w or less, or about 0.025% w/w or less of Compound W. In some embodiments, the produced pharmaceutical grade migalastat has 0.15% w/w or less of Compound W, such as 0.1% w/w or less, 0.05 w/w or less, or 0.025% w/w or less of Compound W. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of Compound W.

In some embodiments, the produced pharmaceutical grade migalastat has about 0.15% w/w or less of Compound U, such as about 0.1% w/w or less, about 0.05 w/w or less, or about 0.025% w/w or less of Compound U. In some embodiments, the produced pharmaceutical grade migalastat has 0.15% w/w or less of Compound U, such as 0.1% w/w or less, 0.05 w/w or less, or 0.025% w/w or less of Compound U. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of Compound U.

In some embodiments, the produced pharmaceutical grade migalastat has about 0.15% w/w or less of Compound V, such as about 0.1% w/w or less, about 0.05 w/w or less, or about 0.025% w/w or less of Compound V. In some embodiments, the produced pharmaceutical grade migalastat has 0.15% w/w or less of Compound V, such as 0.1% w/w or less, 0.05 w/w or less, or 0.025% w/w or less of Compound V. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of Compound V.

In some embodiments, the produced pharmaceutical grade migalastat has about 0.15% w/w or less of Compound Y, such as about 0.1% w/w or less, about 0.05 w/w or less, or about 0.025% w/w or less of Compound Y. In some embodiments, the produced pharmaceutical grade migalastat has 0.15% w/w or less of Compound Y, such as 0.1% w/w or less, 0.05 w/w or less, or 0.025% w/w or less of Compound Y. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of Compound Y.

In some embodiments, the produced pharmaceutical grade migalastat has about 0.15% w/w or less of Compound BB, such as about 0.1% w/w or less, about 0.05 w/w or less, or about 0.025% w/w or less of Compound BB. In some embodiments, the produced pharmaceutical grade migalastat has 0.15% w/w or less of Compound BB, such as 0.1% w/w or less, 0.05 w/w or less, or 0.025% w/w or less of Compound BB. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of Compound BB.

In some embodiments, the pharmaceutical grade migalastat has about 0.3% w/w or less of methanol, such as about 0.2% w/w or less, about 0.1% w/w or less, or about 0.05% w/w or less of methanol. In some embodiments, the pharmaceutical grade migalastat has 0.3% w/w or less of methanol, such as 0.2% w/w or less, 0.1% w/w or less, or 0.05% w/w or less of methanol. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of methanol.

In some embodiments, the pharmaceutical grade migalastat has about 0.5% w/w or less of ethanol, such as about 0.4% w/w or less, about 0.3% w/w, about 0.2% w/w or less, about 0.1% w/w or less, or about 0.05% w/w or less of ethanol. In some embodiments, the pharmaceutical grade migalastat has 0.5% w/w or less of ethanol, such as 0.4% w/w or less, 0.3% w/w, 0.2% w/w or less, 0.1% w/w or less, or 0.05% w/w or less of ethanol. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of ethanol.

In some embodiments, the pharmaceutical grade migalastat has about 0.2% w/w or less of water, such as about 0.1% w/w or less, or about 0.05% w/w or less of water. In some embodiments, the pharmaceutical grade migalastat has 0.2% w/w or less of water, such as 0.1% w/w or less, or 0.05% w/w or less of water. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of water.

In some embodiments, the pharmaceutical grade migalastat has about 0.2% w/w or less of residue on ignition, such as about 0.1% w/w or less, or about 0.05% w/w or less of residue on ignition. In some embodiments, the pharmaceutical grade migalastat has 0.2% w/w or less of residue on ignition, such as 0.1% w/w or less, or 0.05% w/w or less of residue on ignition. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of residue on ignition.

In some embodiments, the pharmaceutical grade migalastat has about 0.15 ppm or less of arsenic, such as about 0.1 ppm or less, or about 0.05 ppm or less of arsenic. In some embodiments, the pharmaceutical grade migalastat has 0.15 ppm or less of arsenic, such as 0.1 ppm or less, or 0.05 ppm or less of arsenic. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of arsenic.

In some embodiments, the pharmaceutical grade migalastat has about 0.5 ppm or less of cadmium, such as about 0.4 ppm or less, about 0.3 ppm or less, about 0.2 ppm or less, about 0.1 ppm or less, or about 0.05 ppm or less of cadmium. In some embodiments, the pharmaceutical grade migalastat has 0.5 ppm or less of cadmium, such as 0.4 ppm or less, 0.3 ppm or less, 0.2 ppm or less, 0.1 ppm or less, or 0.05 ppm or less of cadmium. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of cadmium.

In some embodiments, the pharmaceutical grade migalastat has about 1.5 ppm or less of mercury, such as about 1 ppm or less, about 0.9 ppm or less, about 0.8 ppm or less, about 0.7 ppm or less, about 0.6 ppm or less, about 0.5 ppm or less, about 0.4 ppm or less, about 0.3 ppm or less, about 0.2 ppm or less, about 0.1 ppm or less, or about 0.05 ppm or less of mercury. In some embodiments, the pharmaceutical grade migalastat has 1.5 ppm or less of mercury, such as 1 ppm or less, 0.9 ppm or less, 0.8 ppm or les, 0.7 ppm or less, 0.6 ppm or less, 0.5 ppm or less, 0.4 ppm or less, 0.3 ppm or less, 0.2 ppm or less, 0.1 ppm or less, or 0.05 ppm or less of mercury. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of mercury.

In some embodiments, the pharmaceutical grade migalastat has about 0.5 ppm or less of lead, such as about 0.4 ppm or less, about 0.3 ppm or less, about 0.2 ppm or less, about 0.1 ppm or less, or about 0.05 ppm or less of lead. In some embodiments, the pharmaceutical grade migalastat has 0.5 ppm or less of lead, such as 0.4 ppm or less, 0.3 ppm or less, 0.2 ppm or less, 0.1 ppm or less, or 0.05 ppm or less of lead. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of lead.

In some embodiments, the pharmaceutical grade migalastat has about 10 ppm or less of palladium, such as about 9 ppm or less, about 8 ppm or less, about 7 ppm or less, about 6 ppm or less, about 5 ppm or less, about 4 ppm or less, about 3 ppm or less, about 2 ppm or less, about 1 ppm or less, or about 0.5 ppm or less of palladium. In some embodiments, the pharmaceutical grade migalastat has 10 ppm or less of palladium, such as 9 ppm or less, 8 ppm or less, 7 ppm or less, 6 ppm or less, 5 ppm or less, 4 ppm or less, 3 ppm or less, 2 ppm or less, 1 ppm or less, or 0.5 ppm or less of palladium. In some embodiments, the pharmaceutical grade migalastat has no detectable amount of palladium.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 0.1% or less of Compound CC, such as about 0.05% or less, or about 0.2% or less of Compound CC. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 0.1% or less of Compound CC, such as 0.05% or less, or 0.2% or less of Compound CC. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of Compound CC.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 0.1% or less of Compound A, such as about 0.05% or less, or about 0.2% or less of Compound A. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 0.1% or less of Compound A, such as 0.05% or less, or 0.2% or less of Compound A. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of Compound A.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 0.1% or less of Compound EE, such as about 0.05% or less, or about 0.2% or less of Compound EE. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 0.1% or less of Compound EE, such as 0.05% or less, or 0.2% or less of Compound EE. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of Compound EE.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 0.1% or less of Compound DD, such as about 0.05% or less, or about 0.2% or less of Compound DD. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 0.1% or less of Compound DD, such as 0.05% or less, or 0.2% or less of Compound DD. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of Compound DD.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 12 μg or less of Compound D per gram of pharmaceutical grade migalastat hydrochloride, such as about 10 μg or less, about 8 μg or less, about 5 μg or less, about 4 μg or less, about 3 μg or less, about 2 μg or less, about 1 μg or less, or about 0.5 μg or less of Compound D per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 12 μg or less of Compound D per gram of pharmaceutical grade migalastat hydrochloride, such as 10 μg or less, 8 μg or less, 5 μg or less, 4 μg or less, 3 μg or less, 2 μg or less, 1 μg or less, or 0.5 μg or less of Compound D per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of Compound D per gram of pharmaceutical grade migalastat hydrochloride.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 12 μg or less of Compound F per gram of pharmaceutical grade migalastat hydrochloride, such as about 10 μg or less, about 8 μg or less, about 5 μg or less, about 4 μg or less, about 3 μg or less, about 2 μg or less, about 1 μg or less, or about 0.5 μg or less of Compound F per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 12 μg or less of Compound F per gram of pharmaceutical grade migalastat hydrochloride, such as 10 μg or less, 8 μg or less, 5 μg or less, 4 μg or less, 3 μg or less, 2 μg or less, 1 μg or less, or 0.5 μg or less of Compound F per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of Compound F per gram of pharmaceutical grade migalastat hydrochloride.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 12 μg or less of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside per gram of pharmaceutical grade migalastat hydrochloride, such as about 10 μg or less, about 8 μg or less, about 5 μg or less, about 4 μg or less, about 3 μg or less, about 2 μg or less, about 1 μg or less, or about 0.5 μg or less of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 12 μg or less of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside per gram of pharmaceutical grade migalastat hydrochloride, such as 10 μg or less, 8 μg or less, 5 μg or less, 4 μg or less, 3 μg or less, 2 μg or less, 1 μg or less, or 0.5 μg or less of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside per gram of pharmaceutical grade migalastat hydrochloride.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 12 μg or less of Compound N per gram of pharmaceutical grade migalastat hydrochloride, such as about 10 μg or less, about 8 μg or less, about 5 μg or less, about 4 μg or less, about 3 μg or less, about 2 μg or less, about 1 μg or less, or about 0.5 μg or less of Compound N per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 12 μg or less of Compound N per gram of pharmaceutical grade migalastat hydrochloride, such as 10 μg or less, 8 μg or less, 5 μg or less, 4 μg or less, 3 μg or less, 2 μg or less, 1 μg or less, or 0.5 μg or less of Compound N per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of Compound N per gram of pharmaceutical grade migalastat hydrochloride.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 12 μg or less of Compound Q per gram of pharmaceutical grade migalastat hydrochloride, such as about 10 μg or less, about 8 μg or less, about 5 μg or less, about 4 μg or less, about 3 μg or less, about 2 μg or less, about 1 μg or less, or about 0.5 μg or less of Compound Q per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 12 μg or less of Compound Q per gram of pharmaceutical grade migalastat hydrochloride, such as 10 μg or less, 8 μg or less, 5 μg or less, 4 μg or less, 3 μg or less, 2 μg or less, 1 μg or less, or 0.5 μg or less of Compound Q per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of Compound Q per gram of pharmaceutical grade migalastat hydrochloride.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 12 μg or less of Compound P per gram of pharmaceutical grade migalastat hydrochloride, such as about 10 μg or less, about 8 μg or less, about 5 μg or less, about 4 μg or less, about 3 μg or less, about 2 μg or less, about 1 μg or less, or about 0.5 μg or less of Compound P per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 12 μg or less of Compound P per gram of pharmaceutical grade migalastat hydrochloride, such as 10 μg or less, 8 μg or less, 5 μg or less, 4 μg or less, 3 μg or less, 2 μg or less, 1 μg or less, or 0.5 μg or less of Compound P per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of Compound P per gram of pharmaceutical grade migalastat hydrochloride.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 12 μg or less of Compound X per gram of pharmaceutical grade migalastat hydrochloride, such as about 10 μg or less, about 8 μg or less, about 5 μg or less, about 4 μg or less, about 3 μg or less, about 2 μg or less, about 1 μg or less, or about 0.5 μg or less of Compound X per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 12 μg or less of Compound X per gram of pharmaceutical grade migalastat hydrochloride, such as 10 μg or less, 8 μg or less, 5 μg or less, 4 μg or less, 3 μg or less, 2 μg or less, 1 μg or less, or 0.5 μg or less of Compound X per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of Compound X per gram of pharmaceutical grade migalastat hydrochloride.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 12 μg or less of ethyl chloride per gram of pharmaceutical grade migalastat hydrochloride, such as about 10 μg or less, about 8 μg or less, about 5 μg or less, about 4 μg or less, about 3 μg or less, about 2 μg or less, about 1 μg or less, or about 0.5 μg or less of ethyl chloride per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 12 μg or less of ethyl chloride per gram of pharmaceutical grade migalastat hydrochloride, such as 10 μg or less, 8 μg or less, 5 μg or less, 4 μg or less, 3 μg or less, 2 μg or less, 1 μg or less, or 0.5 μg or less of ethyl chloride per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of ethyl chloride per gram of pharmaceutical grade migalastat hydrochloride.

In some embodiments, the pharmaceutical grade migalastat hydrochloride contains about 12 μg or less of methyl chloride per gram of pharmaceutical grade migalastat hydrochloride, such as about 10 μg or less, about 8 μg or less, about 5 μg or less, about 4 μg or less, about 3 μg or less, about 2 μg or less, about 1 μg or less, or about 0.5 μg or less of methyl chloride per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 12 μg or less of methyl chloride per gram of pharmaceutical grade migalastat hydrochloride, such as 10 μg or less, 8 μg or less, 5 μg or less, 4 μg or less, 3 μg or less, 2 μg or less, 1 μg or less, or 0.5 μg or less of methyl chloride per gram of pharmaceutical grade migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains no detectable amount of methyl chloride per gram of pharmaceutical grade migalastat hydrochloride.

In some embodiments, the pharmaceutical grade migalastat hydrochloride has about 0.1% or less of any unspecified impurity, such as about 0.05% or less, about 0.03% or less, about 0.02% or less, or about 0.01% or less of unspecified impurity. In some embodiments, the pharmaceutical grade migalastat hydrochloride has 0.1% or less of any unspecified impurity, such as 0.05% or less, 0.03% or less, 0.02% or less, or 0.01% or less of unspecified impurity.

In some embodiments, the pharmaceutical grade migalastat hydrochloride has about 0.5% or less of total impurities, such as about 0.4% or less, about 0.3% or less, about 0.2% or less, about 0.1% or less, or about 0.05% or less of total impurities. In some embodiments, the pharmaceutical grade migalastat hydrochloride has 0.5% or less of total impurities, such as 0.4% or less, 0.3% or less, 0.2% or less, 0.1% or less, or 0.05% or less of total impurities.

Batch Migalastat Hydrochloride Production

Also provided are methods of producing batches of migalastat hydrochloride, or an intermediate thereof. For instance, in some embodiments 1,2,3,6-tetrapivaloyl-D-galactofuranoside is produced from about 1 kg or more of D-(+)-galactose, such as about 5 kg or more, about 10 kg or more, about 20 kg or more, about 29 kg or more, about 30 kg or more, about 40 kg or more, about 50 kg or more, about 55 kg or more, about 60 kg or more, about 70 kg or more, about 80 kg or more, about 90 kg or more, about 100 kg or more, about 5 kg to about 75 kg, about 10 kg to about 70 kg, about 15 kg to about 65 kg, about 15 kg to about 60 kg, about 20 kg to about 55 kg, about 22 kg to about 55 kg, about 22 kg, about 25 kg, about 30 kg, about 35 kg, about 40 kg, about 45 kg, about 50 kg, or about 55 kg of D-(+)-galactose. In some embodiments 1,2,3,6-tetrapivaloyl-D-galactofuranoside is produced from 1 kg or more of D-(+)-galactose, such as 5 kg or more, 10 kg or more, 20 kg or more, 29 kg or more, 30 kg or more, 40 kg or more, 50 kg or more, 55 kg or more, 60 kg or more, 70 kg or more, 80 kg or more, 90 kg or more, 100 kg or more, 5 kg to 75 kg, 10 kg to 70 kg, 15 kg to 65 kg, 15 kg to 60 kg, 20 kg to 55 kg, 22 kg to 55 kg, 22 kg, 25 kg, 30 kg, 35 kg, 40 kg, 45 kg, 50 kg, or 55 kg of D-(+)-galactose.

In some embodiments, 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is produced from about 1 kg or more of 1,2,3,6-tetrapivaloyl-D-galactofuranoside, such as about 5 kg or more, about 10 kg or more, about 20 kg or more, about 30 kg or more, about 36 kg or more, about 40 kg or more, about 50 kg or more, about 60 kg or more, about 70 kg or more, about 80 kg or more, about 84 kg or more, about 90 kg or more, about 100 kg or more, about 5 kg to about 100 kg, about 15 kg to about 95 kg, about 25 kg to about 90 kg, about 36 kg to about 84 kg, about 36 kg, about 45 kg, about 55 kg, about 65 kg, about 75 kg, or about 84 kg of 1,2,3,6-tetrapivaloyl-D-galactofuranoside. In some embodiments, 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is produced from 1 kg or more of 1,2,3,6-tetrapivaloyl-D-galactofuranoside, such as 5 kg or more, 10 kg or more, 20 kg or more, 30 kg or more, 36 kg or more, 40 kg or more, 50 kg or more, 60 kg or more, 70 kg or more, 80 kg or more, 84 kg or more, 90 kg or more, 100 kg or more, 5 kg to about 100 kg, 15 kg to 95 kg, 25 kg to 90 kg, 36 kg to 84 kg, 36 kg, 45 kg, 55 kg, 65 kg, 75 kg, or 84 kg of 1,2,3,6-tetrapivaloyl-D-galactofuranoside.

In some embodiments, intermediate grade migalastat hydrochloride is produced from about 1 kg or more of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside, such as about 5 kg or more, about 10 kg or more, about 20 kg or more, about 29 kg or more, about 30 kg or more, about 40 kg or more, about 50 kg or more, about 55 kg or more, about 60 kg or more, about 70 kg or more, about 80 kg or more, about 90 kg or more, about 100 kg or more, about 5 kg to about 50 kg, about 10 kg to about 45 kg, about 15 kg to about 40 kg, about 20 kg to about 35 kg, about 25 kg to about 31 kg, about 25 kg, about 26 kg, about 27 kg, about 28 kg, about 29 kg, about 30 kg, or about 31 kg of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside. In some embodiments, intermediate grade migalastat hydrochloride is produced from 1 kg or more of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside, such as 5 kg or more, 10 kg or more, 20 kg or more, 29 kg or more, 30 kg or more, 40 kg or more, 50 kg or more, 55 kg or more, 60 kg or more, 70 kg or more, 80 kg or more, 90 kg or more, 100 kg or more, 5 kg to 50 kg, 10 kg to 45 kg, 15 kg to 40 kg, 20 kg to 35 kg, 25 kg to 31 kg, 25 kg, 26 kg, 27 kg, 28 kg, 29 kg, 30 kg, or 31 kg of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside.

In some embodiments, the pharmaceutical grade migalastat hydrochloride is produced from about 1 kg or more of intermediate grade migalastat hydrochloride, such as about 5 kg or more, about 10 kg or more, about 20 kg or more, about 29 kg or more, about 30 kg or more, about 40 kg or more, about 50 kg or more, about 55 kg or more, about 60 kg or more, about 70 kg or more, about 80 kg or more, about 90 kg or more, about 100 kg or more, about 5 kg to about 50 kg, about 6 kg to about 40 kg, about 7 kg to about 30 kg, about 8 kg to about 35 kg, about 10 kg to about 20 kg, about 11.5 kg to about 17.3 kg, about 11.5 kg, about 12 kg, about 13 kg, about 14 kg, about 15 kg, about 16 kg, or about 17.3 kg of intermediate grade migalastat hydrochloride.

In some embodiments, the pharmaceutical grade migalastat hydrochloride is produced from 1 kg or more of intermediate grade migalastat hydrochloride, such as 5 kg or more, 10 kg or more, 20 kg or more, 29 kg or more, 30 kg or more, 40 kg or more, 50 kg or more, 55 kg or more, 60 kg or more, 70 kg or more, 80 kg or more, 90 kg or more, 100 kg or more, 5 kg to 50 kg, 6 kg to 40 kg, 7 kg to 30 kg, 8 kg to 35 kg, 10 kg to 20 kg, 11.5 kg to 17.3 kg, 11.5 kg, 12 kg, 13 kg, 14 kg, 15 kg, 16 kg, or 17.3 kg of intermediate grade migalastat hydrochloride.

In some embodiments, the produced batch of pharmaceutical grade migalastat hydrochloride is from about 1 kg or more, such as about 5 kg or more, about 10 kg or more, about 20 kg or more, about 29 kg or more, about 30 kg or more, about 40 kg or more, about 50 kg or more, about 55 kg or more, about 60 kg or more, about 70 kg or more, about 80 kg or more, about 90 kg or more, about 100 kg or more, about 5 kg to about 50 kg, about 6 kg to about 40 kg, about 7 kg to about 30 kg, about 8 kg to about 35 kg, about 10 kg to about 20 kg, about 11.5 kg to about 17.3 kg, about 11.5 kg, about 12 kg, about 13 kg, about 14 kg, about 15 kg, about 16 kg, or about 17.3 kg. In some embodiments, the produced batch of pharmaceutical grade migalastat hydrochloride is 1 kg or more, such as 5 kg or more, 10 kg or more, 20 kg or more, 29 kg or more, 30 kg or more, 40 kg or more, 50 kg or more, 55 kg or more, 60 kg or more, 70 kg or more, 80 kg or more, 90 kg or more, 100 kg or more, 5 kg to 50 kg, 6 kg to 40 kg, 7 kg to 30 kg, 8 kg to 35 kg, 10 kg to 20 kg, 11.5 kg to 17.3 kg, 11.5 kg, 12 kg, 13 kg, 14 kg, 15 kg, 16 kg, or 17.3 kg.

Batch Validation and Distribution

Also provided are methods of determining the purity of a batch of pharmaceutical grade migalastat hydrochloride, or an intermediate thereof. Also provided are methods of validating a batch of pharmaceutical grade migalastat hydrochloride, or an intermediate thereof. In some embodiments, a batch of pharmaceutical grade migalastat hydrochloride is validated as suitable for clinical use if it contains levels of impurities within the amounts disclosed herein, or if it does not contain detectable amounts of such impurities.

Impurities can be determined by any suitable method, such as infrared spectroscopy, high performance liquid chromatography (HPLC), hydrophilic interaction liquid chromatography (HILIC), gas chromatography, nuclear magnetic resonance (NMR), mass spectrometry (MS), inductively coupled plasma mass spectroscopy (ICP-MS), Karl Fischer titration, and/or residue on ignition.

Some embodiments comprise using an impurity or a salt thereof as a reference standard to detect amounts (e.g., trace amounts) of the impurity in a batch of migalastat hydrochloride, or an intermediate thereof. Some embodiments comprise producing the reference standard.

Some embodiments comprise obtaining a sample from a batch of migalastat hydrochloride, or an intermediate thereof, and determining an amount of one or more impurities in the sample.

In some embodiments, impurities are set forth based on % w/w (e.g., based on the weight of the migalastat or intermediate in which the impurity is measured). In some embodiments, the impurities are set forth based on % area (e.g., based on the area under an HPLC peak associated with the impurity as compared to the total area under HPLC chromatographic peaks, which can be detected, e.g., using HILIC or UV detection). % area can be calculated as set forth in NORMAN DYSON, CHROMATOGRAPHIC INTEGRATION METHODS (The Royal Society of Chemistry, 2d ed. 1998), which is incorporated herein by reference in its entirety. In some embodiments, impurities are set forth based on an amount or based on ppm. Unless otherwise specified, a particularly disclosed impurity percentage is meant to encompass amounts as calculated based on % w/w and/or % area. In other words: in some embodiments, the % impurity is calculated based on % w/w; in some embodiments the % impurity is calculated based on % area. If an impurity amount is specifically tied to a type of calculation (e.g., % w/w), it is understood that such a calculation is not limiting on the scope of the disclosure, and so the impurity amount can be determined using alternative calculations (e.g., % area) if desired. While exemplary validation components and values are discussed below for particular impurities, other components and values (e.g., provided in preceding paragraphs or in the working examples) can also be used for batch validation.

In some embodiments, a batch of 1,2,3,6-tetrapivaloyl-D-galactofuranoside is validated by determining the amount of Compound B in the batch. In some embodiments, the batch of 1,2,3,6-tetrapivaloyl-D-galactofuranoside has 3% area or less of Compound B.

In some embodiments, a batch of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is validated by determining the amount of one or more (or all) of 1,2,3,6-tetrapivaloyl-D-galactofuranoside, Compound E, Compound G, Compound J, Compound I, Compound K, Compound N, and Compound O in the batch. In some embodiments, the batch contains 0.6% area or less of 1,2,3,6-tetrapivaloyl-D-galactofuranoside, 0.3% area or less of Compound E, 0.3% area or less of Compound G, 3% area or less of Compound J, 0.6% area or less of Compound I, 0.3% area or less of Compound K, 1% area or less of Compound N, and 0.3% area of less of Compound O.

In some embodiments, a batch of intermediate grade migalastat hydrochloride is validated by determining the amounts of one or more (or all) of Compound U, Compound V, Compound Y, Compound W, and Compound BB in the batch of intermediate grade migalastat hydrochloride. In some embodiments, the batch contains 0.4% w/w or less of Compound U, 0.4% w/w or less of Compound V, 0.25% w/w or less of Compound Y, 0.15% w/w or less of Compound W, and 0.3% w/w or less of Compound BB. In some embodiments, the batch contains 0.4% area or less of Compound U, 0.4% area or less of Compound V, 0.25% area or less of Compound Y, 0.15% area or less of Compound W, and 0.3% area or less of Compound BB.

In some embodiments, a batch of pharmaceutical grade migalastat hydrochloride is validated by determining the amounts of one or more (or all) of Compound W, Compound U, Compound V, Compound Y, Compound BB, methanol, ethanol, water, residue on ignition, arsenic, cadmium, mercury, lead, and palladium in the batch of migalastat hydrochloride. In some embodiments, the pharmaceutical grade migalastat hydrochloride contains 0.15% w/w or less of Compound W, 0.15% w/w or less of Compound U, 0.15% w/w or less of Compound V, 0.15% w/w or less of Compound Y, 0.15% w/w or less of Compound BB, 0.3% w/w or less of methanol, 0.5% w/w or less of ethanol, 0.2% w/w or less of water, and 0.2% w/w or less of residue on ignition, each based on the weight of the migalastat hydrochloride, and 0.15 ppm or less of arsenic, 0.5 ppm or less of cadmium, 1.5 ppm or less of mercury, 0.5 ppm or less of lead, and 10 ppm or less of palladium. Some embodiments comprise validating a batch of migalastat hydrochloride if it meets the specifications set forth in Example 1 below.

In some embodiments, a validated batch of pharmaceutical grade migalastat hydrochloride is assessed as suitable for medical use in a subject. In some embodiments, the validated batch of migalastat hydrochloride is a commercial batch of migalastat hydrochloride. In some embodiments, the validated batch is distributed. In some embodiments, a batch that does not meet validation standards is not distributed. In some embodiments, a batch that does not meet validation standards is reprocessed until standards are met.

In some embodiments, a pregelatinized starch is added to validated migalastat hydrochloride and the mixture is screened, e.g. using a rotating impeller screening mill. In some embodiments, the screening is performed using an about 457 micron screen, such as a 457 micron screen.

In some embodiments, the validated migalastat hydrochloride is blended. The blending can comprise pre-lubrication and/or lubrication blending steps. Exemplary pre-lubrication blending steps involve blending migalastat hydrochloride and pregelatinized starch, e.g., using a diffusion mixer. Exemplary migalastat hydrochloride: pregelatinized starch ratios include about 1:1 to about 5:1, such as about 2:1 to about 4:1, about 3:1 to about 3.5:1, about 3:1, about 3.1:1. About 3.2:1, about 3.3:1, about 3.4:1, or about 3.5:1. Exemplary ratios also include 1:1 to 5:1, such as 2:1 to 4:1, 3:1 to 3.5:1, 3:1, 3.1:1. 3.2:1, 3.3:1, 3.4:1, or 3.5:1. In some embodiments the diffusion mixing is performed at about 100-300 revolutions for about 5 to 15 minutes at a speed of about 20 rpm.

Exemplary lubrication blending steps include adding magnesium stearate to a pre-lubrication mix. Example migalastat hydrochloride: magnesium stearate ratios include about 100:1 to about 200:1, such as about 125:1 to about 175:1, about 145:1 to about 155:1, about 150:1, about 152:1, about 153:1, about 154:1, or about 155:1. Example migalastat hydrochloride:magnesium stearate ratios also include 100:1 to 200:1, such as 125:1 to 175:1, 145:1 to 155:1, 150:1, 152:1, 153:1, 154:1, or 155:1. In some embodiments, the lubrication blending step is conducted using a diffusion mixer, e.g., at about 60 revolutions for about 3 minutes at about 20 rpm.

In some embodiments, the validated migalastat hydrochloride is divided in whole or in part into portions, such as 123 mg portions FBE of migalastat (e.g., 150 mg migalastat hydrochloride). In some embodiments, the portions of migalastat hydrochloride are encapsulated, e.g., in a capsule. In some embodiments, the encapsulation is with an encapsulation machine. In some embodiments, the encapsulation machine targets a capsule fill weight of about 196 mg.

In some embodiments, the encapsulated migalastat hydrochloride is packaged, e.g., in a container closure system. The container closure system can be flexible or semirigid, and can be composed entirely, primarily, or partially of plastic. In some embodiments, the migalastat is packaged in a paperboard package, a flexible pouch, a plastic container (e.g., cup or tray) having a heat-sealed flexible lid, or a plastic container (e.g., can) with double-seamed metal ends. The container closure system can comprise one or more hermetic seals that prevent contamination of the migalastat, oxidation of the migalastat, and/or exposure of the migalastat to external environmental conditions. In some embodiments, the container closure system comprises primary packaging (the immediate packaging that comes into contact with the consumable migalastat product). Optionally, the container closure system comprises secondary packaging, which comprises an exterior packaging of the primary packaging.

Some embodiments comprise packaging one or more units of migalastat. Packaging can comprise inserting one or more units of migalastat (e.g., one or more capsules) into a container closure system. In some embodiments, the secondary packaging may be the smallest sellable unit for commerce.

In some embodiments, the packaging comprises polyvinyl chloride (PVC)/polychlorotrifluoroethylene (PCTFE)/PVC laminate film with aluminum foil lidding blister packs.

Some embodiments comprise sealing the packaging (e.g., forming a hermetic seal on the primary packaging). Some embodiments comprise physical or chemical testing of the packaging integrity. The testing can be performed on packaged migalastat. Integrity testing can be performed, for example, via one or more of air leak testing, biotesting, burst testing, chemical etching, compression, squeeze testing, distribution (abuse) testing, dye penetration, electester, electrolytic testing, gas leak detection, incubation, light testing, machine vision, proximity tester, seam scope projection, sound testing, tensile (peel) testing, or vacuum testing. Some embodiments comprise testing the light transmission of the packaging. Some embodiments comprise testing water vapor permeation of the packaging. Exemplary testing protocols are set forth in the US Pharmacopeia sections <661> and <671>, which are incorporated herein by reference in their entireties.

Manufacturing migalastat can comprise repackaging migalastat (e.g., by distributors). Repackaging can comprise removing migalastat from an original container closure system (e.g., from primary packaging and/or secondary packaging). Repackaging can comprise placing migalastat into a new container closure system (e.g., placing unpacked migalastat into a new primary packaging and/or placing packaged migalastat into a secondary container closure system) and optionally hermetically sealing the new container closure system. If repackaging comprises placing unpacked migalastat into a new primary container closure system, the amount of migalastat in each primary container may be the same as or different from the amount in the original packaging. In some embodiments, repackaging comprises packaging migalastat in unit dose container closure systems. If repackaging comprises placing migalastat removed from a secondary container closure system into a new secondary container closure system, the amount of migalastat (e.g., the number of primary containers) in the new secondary container closure system may be the same as or different from the amount in the original secondary packaging. Package integrity testing and/or inspection, as described elsewhere herein, may be performed after the original packaging, after the repackaging, or after both packaging and repackaging. Packaging and/or repackaging may be performed according to Current Good Manufacturing Practices (CGMP). Testing may comprise stability testing on packaged migalastat used to determine the expiration date of the migalastat when stored in a specific type of primary container closure system.

During manufacture of migalastat, one or more of a National Drug Code (NDC) number, a bar code, and a product identifier, a unique serial number, an expiration date, and a lot number may be affixed to or imprinted on one or more of the packages (e.g., primary containers and/or secondary containers) containing the migalastat. The NDC is a 10-digit basic identifier for pharmaceutical products. The product identifier may comprise a standardized graphic. The product identifier may be in a human-readable format and/or on a machine-readable data carrier that conforms to the standards developed by an international standards development organization. The product identifier can comprise the standardized numerical identifier (SNI), lot number, and/or expiration date of the product. The standardized numerical identifier can comprise a set of numbers or characters used to uniquely identify each package or homogeneous case (i.e. a sealed case containing only product that has a single NDC number belonging to a single lot) that is composed of the NDC that corresponds to the specific product (including the particular package configuration) combined with a unique alphanumeric serial number (e.g., of up to 20 characters). In some embodiments, an encoded, standardized bar code (e.g., a linear bar code) is affixed to or imprinted on one or more of the packages. The bar code can comprise the NDC number. In some embodiments, the bar code comprises the NDC and/or any other information. In some embodiments, globally accepted GS1 system data structures and/or symbologies are be used to convey the NDC, a unique serial number, expiration date and lot number, as well as optional quantity information. During manufacture of migalastat a bar code or other machine readable data carrier can be scanned or read by a machine (e.g., by a distributor upon receiving migalastat from a manufacturer) for processing the transport of the migalastat through the chain of commerce and/or manufacturing process or for inventorying the migalastat.

Some embodiments comprise tracing or tracking the manufactured migalastat, e.g., at a batch level, lot level, or package level. In some embodiments, the tracing is performed electronically. In some embodiments, dispensers in a drug supply chain exchange information about a drug and who handled it each time it is sold (e.g., in the US market). In some embodiments, such information comprises transaction information and/or a transaction history. Transaction information can comprise proprietary or established name or names of the product, strength and dosage form of the product, NDC number of the product, container size, number of containers, lot number of the product, date of the transaction, date of the shipment, and/or business name and address of the person from whom and to whom ownership is being transferred.

Tracing can be performed using any suitable system or process. In some embodiments, tracing is performed using paper-based methods. In some embodiments, tracing is performed using electronic-based methods. Examples of tracing methods include paper or electronic versions of invoices, paper versions or packing slips, electronic data interchange (EI) standards, such as advance ship notice (ASN), and electronic product code information services (EPCIS). In some embodiments, email or other web-based platforms are used. In some embodiments, the tracing is performed by scanning a barcode, e.g., that carries transaction information.

Also provided are methods of storing migalastat (e.g., in packaged form) under conditions that promote stability of the migalastat and/or reduce degradation of the migalastat. In some embodiments, the migalastat is stored at a temperature of from about 20° C. to about 25° C., such as about 20° C., about 21° C., about 22° C., about 23° C., about 24° C., or about 25° C. In some embodiments, the migalastat is stored at a temperature of from 20° C. to 25° C., such as 20° C., 21° C., 22° C., 23° C., 24° C., or 25° C. In some embodiments, excursions are permitted between about 150 and about 30° C., such as from 15° C. to 30° C. In some embodiments, packaged migalastat is stored under such conditions for approximately 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12 months. In some embodiments, packaged migalastat is stored under these conditions for at least 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12 months. In some embodiments, packaged migalastat is stored under these conditions for no longer than 12, 24, 36, 48, or 60 months. In some embodiments, migalastat is received from a manufacturer by a distributor and possession can be transferred to a third party (e.g., a pharmacy, hospital, or patient) by the distributor. The distributor may store the migalastat under controlled conditions (e.g., the temperature described above) for a period of time before transferring possession to the third party. Optionally the distributor may package, repackage, or label the packages (e.g., affix to or imprint on the information described elsewhere herein) prior to transferring possession (distributing) to a third party.

Treatment

Also provided are methods of treating a subject having Fabry disease by administering migalastat. Some embodiments comprise administering migalastat or salt thereof in a range of from about 100 mg FBE to about 150 mg FBE. Exemplary doses include about 100 mg FBE, about 105 mg FBE, about 110 mg FBE, about 115 mg FBE, about 120 mg FBE, about 123 mg FBE, about 125 mg FBE, about 130 mg FBE, about 135 mg FBE, about 140 mg FBE, about 145 mg FBE or about 150 mg FBE. Again, it is noted that 150 mg of migalastat hydrochloride is equivalent to 123 mg of the free base form of migalastat. Thus, in one or more embodiments, the dose is 150 mg of migalastat hydrochloride or an equivalent dose of migalastat or a salt thereof other than the hydrochloride salt, administered at a frequency of once every other day.

In some embodiments, the migalastat is administered at a frequency of once every other day. For example, a dose of 123 mg of the migalastat free base can be administered at a frequency of once every other day.

The administration of migalastat or salt thereof may be for a certain period of time. In some embodiments, the migalastat or salt thereof is administered for a duration of at least 28 days, such as at least 30, 60, or 90 days, or at least 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 16, 20, 24, 30 or 36 months, or at least 1, 2, 3, 4 or 5 years. In some embodiments, the migalastat therapy is long-term migalastat therapy of at least 6 months, such as at least 6, 7, 8, 9, 10, 11, 12, 16, 20, 24, 30 or 36 months or at least 1, 2, 3, 4 or 5 years.

Administration of migalastat or salt thereof may be in a formulation suitable for any route of administration, but is preferably administered in an oral dosage form such as a tablet, capsule or solution. As one example, the patient is orally administered capsules each containing 150 mg migalastat hydrochloride or an equivalent dose of migalastat or a salt thereof other than the hydrochloride salt.

Some embodiments comprise administering migalastat to a subject having an HEK assay amenable α-galactosidase A mutation. An α-galactosidase A variant can be categorized as amenable if the resultant mutant α-Gal A activity (measured in the cell lysates) meets two criteria in an in vitro HEK assay: 1) it shows a relative increase of at least 20% compared to the pre-treatment α-Gal A activity, and 2) it shows an absolute increase of at least 3% of the wild-type (normal) α-Gal A activity. In some embodiments, the in vitro HEK assay comprises transfecting Human Embryonic Kidney (HEK-293) cell lines with specific α-galactosidase A variants (mutations) which produce mutant α-Gal A proteins. In the transfected cells, amenability of the GLA variants can be assessed after a 5-day incubation with 10 micromol/L migalastat. A non-limited list of HEK assay amenable α-galactosidase A mutations is set forth in Table 55. A further non-limited list of HEK assay amenable α-galactosidase A mutations is set forth in Table 56.

The following examples are provided to illustrate embodiments of an invention, but it should be understood that the invention is not limited to the specific conditions or details of these examples.

WORKING EXAMPLES Example 1: Migalastat Hydrochloride Specification

A batch of pharmaceutical grade migalastat hydrochloride was prepared with the specifications set forth in Table 1:

!TABLE 1 Migalastat hydrochloride specifications Test Acceptance Criteria Appearance White to almost white solid Identification of Migalastat Hydrochloride The spectrum of the sample by Infrared Spectroscopy is concordant with that of migalastat HCl reference material Identification of Migalastat HCl by HPLC Matches the retention time of the migalastat HCl reference standard Identification of Chloride Contains chloride Migalastat HCl Content by HPLC (% w/w, 98.0-102.0 ‘as is’) Drug-related Impurities Content by HPLC (% w/w) Compound W Not greater than 0.15 Compound U Not greater than 0.15 Any Unspecified Impurity Not greater than 0.10 Compound V, Compound Y, and Compound BB Content by HILIC (% w/w) Compound V Not greater than 0.15 Compound Y Not greater than 0.15 Compound BB Not greater than 0.15 Total Impurities by HPLC and HILIC Not greater than 0.5 (% w/w) Methanol and Ethanol Content by GC (% w/w) Methanol Not greater than 0.3 Ethanol Not greater than 0.5 Water Content by Karl Fischer (% w/w) Not greater than 0.2 Residue on Ignition (% w/w) Not greater than 0.2 Heavy Metals by ICP-MS (ppm) As Not greater than 0.15 Cd Not greater than 0.5 Hg Not greater than 1.5 Pb Not greater than 0.5 Palladium Content by ICP-MS (ppm) Not greater than 10 HPLC = High performance liquid chromatography; HILIC = Hydrophilic interaction liquid chromatography; GC = gas chromatography; ICP-MS = Inductively coupled plasma mass spectroscopy

The batch was incorporated into capsules, each of which contained 123 mg of migalastat. The specifications for the capsules are set forth in Table 2:

TABLE 2 Migalastat hard capsule specifications Test Acceptance Criteria Description A size “2” capsule, containing white to pale brown powder. Identification of Migalastat The spectrum of the sample is Hydrochloride by IR concordant with that of the reference material. Identification of Migalastat The retention time of the Hydrochloride by HPLC migalastat peak in the sample chromatogram corresponds to that in the standard chromatogram. Migalastat Content by HPLC 95.0-105.0 (% w/w) Drug-related Impurities Content by HPLC (% w/w) Any individual degradation product Not greater than 0.2 Total degradation products Not greater than 0.5 Uniformity of Dosage Units by Complies with Harmonized Weight/Mass Variation Pharmacopoeia (USP/Ph. Eur./JP) Dissolution (% migalastat released) Not less than 80% (Q) at 15 minutes Microbial enumeration tests Total aerobic microbial count Not greater than 103 cfu/g (TAMC) Total combined yeast/mold count Not greater than 102 cfu/g (TYMC) Specific micro-organisms Escherichia coli Absent in 1 g

Example 2: Migalastat Hydrochloride Production Parameters

Migalastat hydrochloride was produced using the tolerances set forth in Table 3 unless otherwise defined:

TABLE 3 Tolerances used during production of migalastat hydrochloride Variable Tolerance Batch size if no range is given ±20% Key raw material and critical quantity (weight or volume)  ±1% Non-critical quantity (weight or volume)  ±2% Solvents (weight or volume)  ±5% Temperature  ±5° C. Time ±20%

Equipment: Reactors were glass, glass-lined steel, stainless steel, or Hastelloy C and were equipped with appropriate stirring and temperature controls. Filtrations for the purpose of isolating crystalline products were performed using a Hastelloy Nutsche type filter with a metal filter fabric. Other solid materials, like inorganic salts, were separated from product-containing solutions by use of lens-shaped or GAF-filters (Hastelloy, ECTFE coated or stainless steel) with paper or textile inserts.

A flow diagram for the synthesis of a batch migalastat hydrochloride is shown in FIG. 1 . The following abbreviations are used in the flowchart: DMF—N,N-Dimethylformamide; DMSO—Dimethylsulfoxide; IPAc—Isopropyl acetate; MeOH—Methanol; DBU—1,8-Diazabicycloundec-7—ene; NaOMe—Sodium methoxide; NaN₃—Sodium azide; EtOH—Ethanol; DIPEA—N,N-Diisopropylethylamine; PivCl—Pivaloyl chloride; HCl—Hydrochloric acid; Tf2O—Trifluoromethanesulfonic acid; Pd/C Palladium on carbon anhydride. As shown in FIG. 1 , the synthesis involved 4 Stages. Batches were produced using the input scale set forth in Table 4 for each of the 4 Stages:

TABLE 4 Manufacturing Batch Scale Stage # Scale Range (Input) 1 29-55 kg 2 36-84 kg 3 25-31 kg 4 11.5-17.3 kg    Stage 1: Preparation of 1,2,3,6-tetrapivaloyl-D-galactofuranoside:

Stage 1 of migalastat hydrochloride production was performed as shown in FIG. 2 , which also demonstrates an impurity formed during Stage 1. Pivaloyl imidazole was reacted with D-(+)-galactose to give 1,2,3,6-tetrapivaloyl-D-galactofuranoside. Pivaloyl imidazole was prepared by mixing pivaloyl chloride and imidazole in toluene. The slurry was filtered and washed with toluene to give a solution of pivaloyl imidazole in toluene (18.4%-28.3% w/w).

Quantities in the following are expressed relative to D-(+)-galactose. 22-55 kg D-(+)-galactose (1 weight) was dissolved by heating in N,N-Dimethylformamide (DMF, 12.10-17.08 weights) at 88-92° C. The solution of pivaloyl imidazole in toluene (4.6-4.8 molar equivalents) was added to the solution of D-(+)-galactose at 77-85° C. The mixture was treated with methanol (0.50-3.0 weights). The resultant mixture was washed with water and the organic layer was separated. The solution was concentrated and heptane (6.27-9.40 weights) added before the mixture was seeded and cooled to −50 to 15° C. Solid 1,2,3,6-tetrapivaloyl-D-galactofuranoside was isolated, washed with heptane, and dried under vacuum with heating at <40° C.

Various batches were produced in which production parameters were varied. It was shown that 1,2,3,6-tetrapivaloyl-D-galactofuranoside could be produced across the production parameter ranges set forth in Table 5. The yield was 23%-33%.

TABLE 5 Summary of Stage 1 process parameters and associated ranges Stage Process Parameter Range Units¹ 1 Pivaloyl imidazole content 18.4-28.3 % w/w DMF quantity 12.10-17.08 weights Galactose dissolution 88-92 ° C. Pivaloyl-imidazole quantity 4.6-4.8 molar equiv Reaction temperature 77-85 ° C. Methanol quantity 0.5-3.0 weights Heptane quantity 6.27-9.40 weights Crystallization temperature −50 to −15 ° C. ¹Weights expressed relative to D-(+)-galactose Stage 2: Preparation of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside:

Stage 2 of migalastat hydrochloride production was performed as shown in FIG. 3 . 1,2,3,6-tetrapivaloyl-D-galactofuranoside was activated with trifluoromethanesulfonic acid anhydride and then reacted with water to give 1,2,3,6-tetrapivaloyl-α-L-altrofuranoside. The resulting intermediate was again activated with trifluoromethanesulfonic acid anhydride and then reacted with sodium azide to give 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside which was isolated.

Quantities are expressed relative to 1,2,3,6-tetrapivaloyl-D-galactofuranoside. Trifluoromethanesulfonic acid anhydride (1.0-1.6 molar equiv.) and pyridine (1.15-1.73 weights) were added to a solution of 36-84 kg 1,2,3,6-tetrapivaloyl-D-galactofuranoside (1 weight) in isopropyl acetate (IPAc). To the resulting reaction mixture (Compound D), water was added and the mixture heated to 55-60° C. The aqueous layer was separated and the organic layer dried by azeotropic distillation before adding IPAc and then 1,8-diazabicycloundec-7-ene (DBU) (0.033-0.066 weights). The resulting IPAc solution of Compound E was washed with aqueous hydrochloric acid (HCl) and then with aqueous pyridine. The solution was dried by azeotropic distillation and diluted with IPAc addition. Trifluoromethanesulfonic acid anhydride (1.0-1.6 molar equiv.) and pyridine (1.15-1.73 weights) were added. The resulting IPAc solution of Compound F was washed with water and added to sodium azide (0.13-0.19 weights) and N,N-diisopropylethylamine (DIPEA) (0.28-0.40 weights) in dimethylsulfoxide (DMSO). The mixture was stirred for at least 1 hour. The resulting 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside mixture was washed with water and the organic layer was concentrated by distillation. The mixture was treated with ethanol (5.64-8.45 weights) and water (4.78-7.17 weights). The solid 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside was isolated by filtration at 10-25° C., washed with methanol (0.79-2.38 weights), and dried under vacuum with heating at <40° C.

Various batches were produced in which production parameters were varied. It was shown that 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside could be produced across the production parameter ranges set forth in Table 6. The yield was 53%-73%. Impurities that are present following Stage 2 are shown in FIG. 4 .

TABLE 6 Summary of Stage 2 process parameters and associated ranges Stage Process Parameter Range Units¹ 2 Trifluoromethanesulfonic acid 1.0-1.6 molar equiv anhydride quantity Pyridine quantity 1.15-1.73 weights Hydrolysis Temperature 55-60 ° C. 1,8-Diazabicycloundec-7-ene 0.033-0.066 weights quantity Trifluoromethanesulfonic acid 1.0-1.6 molar equiv anhydride quantity Pyridine quantity 1.15-1.73 weights Sodium azide quantity 0.13-0.19 weights N,N-diisopropylethylamine quantity 0.28-0.40 weights Ethanol quantity 5.64-8.45 weights Water quantity 4.78-7.17 weights Filtration temperature 10-25 ° C. Methanol wash quantity 0.79-2.38 weights ¹Weights expressed relative to 1,2,3,6-tetrapivaloyl-D-galactofuranoside Stage 3: Preparation of Intermediate Grade Migalastat Hydrochloride:

Stage 3 of migalastat hydrochloride production was performed as shown in FIG. 5 . Impurities that are present following Stage 3 are shown in FIG. 6 . Specific production steps or parameters associated with steps 3a, b, and/or c are shown in FIGS. 7-9 , which are discussed in greater detail below.

25-31 kg of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside was reduced using hydrogen and a palladium catalyst. Following a rearrangement and further hydrogenation, sodium methoxide was added to remove the pivaloyl groups. The product was treated with hydrochloric acid and isolated to give intermediate grade migalastat hydrochloride. Quantities are expressed relative to 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside.

Stage 3a: 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside (1 weight) and 10% palladium catalyst on carbon (0.007-0.013 molar equivalents of palladium) were stirred in methanol (5.54-7.13 weights) under a hydrogen atmosphere. The process was vented several times to release nitrogen, and hydrogen pressure was reapplied each time. After venting, the mixture was stirred at a temperature of 40-50° C. under a hydrogen pressure of 8-10 bar (absolute) for a time of not less than 44 hours. The reaction mixture was filtered to remove the catalyst.

Stage 3b: 30% Sodium methoxide solution in methanol (0.8-1.2 equivalents) was added to the solution of Compound S. The mixture was concentrated by distillation to about 0.5 weights (by volume marker) and 37% hydrochloric acid (2.9-3.2 volumes) was added at 20-45° C. before the mixture was aged at a temperature of 40-55° C. for not more than 10 hours to allow precipitation of the sodium chloride. The suspension was cooled to the filtration temperature of 25-40° C. and the sodium chloride was filtered.

Stage 3c: Ethanol was added over not less than 30 minutes. The intermediate grade migalastat hydrochloride was isolated at a temperature of not less than 15° C., washed with ethanol, and dried.

Various batches were produced in which production parameters were varied. It was shown that intermediate grade migalastat could be produced across the production parameter ranges set forth in Tables 7-8. The yield was 72%-92%.

TABLE 7 Summary of Stage 3 critical process parameters and associated ranges Stage Process Parameter Range Units¹ 3a Palladium catalyst quantity 0.007-0.013 molar equiv Time 44-68 hours Temperature 40-50 ° C. Hydrogen pressure 8-10 bar (abs) Methanol amount 5.54-7.13 weights 3b Filtration temperature 25-40 ° C. Residual weight after about 0.5 weights (by distillation volume marker) Age time NMT 10 hours Age temperature 40-55 ° C. 3c Time for ethanol addition NLT 30 minutes Filtration Temperature NLT 15 ° C. NLT = Not less than; NMT = Not more than; ¹Weights expressed relative to 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside

TABLE 8 Summary of other Stage 3 process parameters and associated ranges Stage Process Parameter Range Units¹ 3b 30% Sodium methoxide quantity 0.8-1.2 molar equiv 37% Hydrochloric acid quantity 2.9-3.2 volumes (by equivalent weights) ¹Weights expressed relative to 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside

Table 9 shows batch analysis data from batches of intermediate grade migalastat hydrochloride manufactured at a range of scales. These data demonstrate that the control of the CQAs in intermediate grade migalastat hydrochloride across a range of scales.

TABLE 9 Impurities Data from Stage 3 at Different Scales Attribute of Specification Intermediate Limit in IG Grade Migalastat Batch Numbers and Input Scale Migalastat HCl 70 g 08 kg 31 kg 31 kg Hydrochloride¹ CQA (% w/w) batch batch batch 1² batch 2² Compound W Y 0.15 <0.05 <0.05 ND ND Compound U Y 0.4 <0.05 <0.05 ND ND Compound AA N 0.15 ND ND ND ND Compound Z N 0.25 <0.05 0.07 0.08 0.05 Any other N 0.10 ND — ND ND impurity Total impurities N 1.5 <0.05 0.07 0.08 0.05 Compound V Y 0.40 0.13 0.08 0.21 0.07 Compound Y Y 0.25 ND <0.05 <0.05 ND Compound BB Y 0.4 0.25 0.25 0.17 0.18 Compound X³ N NA — — 4.8 1.4 NA = Not applicable; ND = Not detected; ¹Drug-related impurity CQAs are highlighted in bold text; ²6 batches were produced at production scale; Batches have been selected to reflect the minimum and maximum levels for CQAs observed; ³Not included on the specification for intermediate grade migalastat hydrochloride. Stage 4: Preparation of Pharmaceutical Grade Migalastat Hydrochloride:

Stage 4 of migalastat hydrochloride production was performed as shown in FIG. 24 , which also shows potential impurities that are present following Stage 4. More particularly, intermediate grade migalastat hydrochloride was recrystallized twice from a mixture of water and ethanol to give migalastat hydrochloride.

For Stage 4a, quantities are expressed relative to intermediate grade migalastat hydrochloride. Stage 4a: 11.5-17.3 kg of intermediate grade migalastat hydrochloride (1 weight) was dissolved in water (1.1-1.4 weights). The temperature was adjusted to 40-60° C., ethanol (8.5-10.4 weights) was added, and the slurry cooled to an isolation temperature of 5-35° C. The product was filtered, washed with ethanol (not less than 1 weight), and dried under vacuum at not more than 80° C.

For Stage 4b, quantities are expressed relative to the Stage 4a product. Stage 4b: The Stage 4a product (1 weight) was dissolved in water. The solution was clarified by filtration and water was added to give a total water quantity of (1.1-1.4 weights). The temperature was adjusted to 40-60° C. and ethanol 1 quantity (1.8-2.0 weights) added over not less than 5 minutes to induce crystallization. Following a hold-time of not less than 5 minutes, ethanol 2 quantity (6.8-8.4 weights) was added over not less than 20 minutes and the mixture was cooled to an isolation temperature of 5-35° C. The migalastat hydrochloride was filtered, washed with ethanol (not less than 1 weight), and dried under vacuum at not more than 80° C. (LOD<0.3%).

Various batches were produced in which production parameters were varied. It was shown that pharmaceutical grade migalastat hydrochloride could be produced across the production parameter ranges set forth in Tables 10-11. The yield was 56%-102%.

TABLE 10 Summary of Stage 4 critical process parameters and associated ranges Stage Process Parameter Range Units¹ 4a Water quantity 1.1-1.4 weights 4b Total water quantity 1.1-1.4 weights Ethanol 1 quantity 1.8-2.0 weights Ethanol 1 addition time NLT 5 minutes Hold time NLT 5 minutes Ethanol 1 addition temperature 40-60 ° C. NLT = Not less than; ¹Weights expressed relative to input amounts for each Stage

TABLE 11 Summary of other Stage 4 process parameters and associated ranges Stage Process Parameter Range Units¹ 4a Solution temperature 40-60 ° C. Ethanol quantity  8.5-10.4 weights Filtration temperature  5-35 ° C. Ethanol quantity (wash) NLT 1 weights Drying temperature ≤80 ° C. 4b Ethanol quantity 2 6.6-8.4 weights Ethanol 2 addition time NLT 20 minutes Filtration temperature  5-35 ° C. Ethanol quantity (wash) NLT 1 weights Drying temperature ≤80 ° C. 1Weights expressed relative to input amounts for each Stage NLT = Not less than; Reprocessing of Intermediate Grade Migalastat Hydrochloride (Stage 3) and Migalastat Hydrochloride (Stage 4):

Stage 3 produces intermediate grade migalastat hydrochloride. Stage 4 recrystallization is a distinct purification process for the final drug substance migalastat hydrochloride. If intermediate grade migalastat hydrochloride does not conform to Stage 3 specifications, it may be processed through the Stage 4a or Stage 4b recrystallization process. The isolated product can be analyzed against both the intermediate grade migalastat hydrochloride and migalastat hydrochloride (API) specifications. The final recrystallization may not have to be repeated if the isolated product from the recrystallization meets the migalastat hydrochloride specification.

If migalastat hydrochloride does not conform to the migalastat hydrochloride specifications, it may be recrystallized by performing the Stage 4b recrystallization process.

Heel of migalastat hydrochloride recovered from the filter drier may be collected in Stage 4a or 4b and reprocessed using the Stage 4b process for the recrystallization of migalastat hydrochloride.

Example 3: Commercial Manufacturing Procedures

FIG. 26 sets forth a flow diagram identifying process controls in place for each unit operation of a commercial process. The controls are a combination of manufacturing operating parameters and in-process control tests. The typical time of manufacture for the drug product is one day for screening and blending of encapsulation blend and two days for encapsulation. Hold time of filled capsules prior to packaging is up to 30 days.

Step 1—Screening

Migalastat hydrochloride and pregelatinized starch were screened using a rotating impeller screening mill (Comil), through a 457 micron screen.

Step 2—Blending of Encapsulation Mix (Pre-Lubrication and Lubrication) Manufacture of the encapsulation mix involved two blending processes, pre-lubrication and lubrication blending.

Pre-lubrication: 4590 g of migalastat hydrochloride and 1380 g of pregelatinized starch were blended using a suitable diffusion mixer, such as 100-300 revolutions, for example 5 to 15 minutes at a speed of 20 rpm.

Lubrication: 30 g of magnesium stearate was added to the pre-lubrication mix and blended for typically 60 revolutions, for example 3 minutes at 20 rpm using a suitable diffusion mixer.

Step 3—Encapsulation

The blend obtained at Step 2 was encapsulated using a suitable encapsulation machine to the target capsule fill weight of 196 mg. In-process control tests for filled capsule weight (individual and mean), closed capsule length, and description were applied at regular intervals throughout the encapsulation run.

Step 4—Primary Packaging and Testing

The capsules from Step 3 were filled into polyvinyl chloride (PVC)/polychlorotrifluoroethylene (PCTFE)/PVC laminate film with aluminum foil lidding blister packs using suitable automated blister packaging equipment. A seal integrity test was performed at the start of packaging and at appropriate intervals for the duration of the packaging process.

Reprocessing Operations

Capsules from blisters failing the seal integrity test may be reprocessed in Step 4.

Example 4: Controlling Stage 1 Impurities

Spiking and purging studies were conducted to determine the maximum tolerated dose of impurities in D-(+)-galactose that could be used to produce 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside with acceptable levels of purity for producing migalastat hydrochloride. Based on these studies, the specification for D-(+)-galactose was set to total impurities of less than 2% w/w. The tolerable levels of impurities are set forth in Table 12.

TABLE 12 Impurity standards used for setting specification limits in D-(+)-galactose Observed Levels in D- Proposed Maximum (+)-galactose Specification Demonstrated Batches n = 2 Limit Impurity Tolerance (% area)¹ (% area) (% area)

4 <0.1 2² Largest unidentified disaccharide 2 0.5%-0.66% 2² impurity

4 .21 0.1 2²

3 <0.1 2²

2 <0.1 2² ¹From spiking and purging studies, it was shown that the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside specification will be met when the impurity is present in D-(+)-galactose at this level; ²Controlled under the specification limit for total impurities.

Impurity standards used in the spiking and purging studies are set forth in Table 13.

TABLE 13 Impurity standards used for setting specification limits in D-(+)-galactose Brief description of impurity standard origin Impurity and quality

Commercial material, >98% purity Largest unidentified disaccharide impurity Commercial disaccharide material, >98% purity

Commercial material, >98% purity

Commercial material, >98% purity

Commercial material, >98% purity

Example 5: Controlling Stage 2 Impurities

Spiking and purging studies were conducted to determine the maximum tolerated dose of impurities in 1,2,3,6-tetrapivaloyl-D-galactofuranoside that could be used to produce 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside with acceptable levels of purity for producing migalastat hydrochloride. Based on these studies, it was determined that Compound B was present in 1,2,3,6-tetrapivaloyl-D-galactofuranoside at greater than 1% area. Compound B is an intermediate in the conversion of D-(+)-galactose to 1,2,3,6-tetrapivaloyl-D-galactofuranoside.

The studies showed that the tolerable levels of this impurity that are set forth in Table 14.

TABLE 14 Data Used for Setting Impurity Specification Limits in 1,2,3,6-tetrapivaloyl-D- galactofuranoside Observed Levels in 1,2,3,6- tetrapivaloyl-D- Maximum galactofuranoside Proposed Demonstrated Batches n = 14 Specification Impurity Tolerance (% area)¹ (% area) Limit (% area)

2.9 1.5-2.5 3 ¹From spiking and purging studies, it was shown that the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside specification will be met when the impurity is present in 1,2,3,6-tetrapivaloyl-D-galactofuranoside at this level.

Impurity standards used in the spiking and purging studies are set forth in Table 15.

TABLE 15 Impurity standards used for setting specification limits in 1,2,3,6-tetrapivaloyl-D- galactofuranoside Impurity Brief description of impurity standard origin and quality

Synthesized and purified by preparatory chromatography. High performance liquid chromatography (HPLC) purity 92.8% w/w.

Example 6: Controlling Intermediate Grade Migalastat Hydrochloride Impurities

Maximum acceptable levels of each of the impurities potentially present in 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside were determined by including the impurities in the Stage 3 input at various levels. To demonstrate the purging of Compound J, the impurities Compound G and Compound E were each spiked into Stage 3 at 3% w/w. Compound I and Compound K are both transformed into Compound H in Stage 3a; hence, in order to show that the specification limits of 0.6% and 0.3%, respectively, are acceptable, 0.9% of Compound I was spiked into Stage 3.

Batches of the intermediate grade migalastat hydrochloride produced from 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside were analyzed against the intermediate grade migalastat hydrochloride specification. Based on these studies, the tolerable doses of impurities set forth in Table 16 were determined.

TABLE 16 Data used for setting impurity specification limits in 5-azido-5-deoxy-1,2,3,6- tetrapivaloyl-D-galactofuranoside Observed Levels in 5-azido-5- Maximum deoxy-1,2,3,6-tetrapivaloyl-D- Demonstrated galactofuranoside Proposed Tolerance Batches n = 6 Specification Impurity (% w/w)¹ (% area) Limit (% area)

2.6 0.16-0.36 0.6

1.3 ND-0.06 0.3²

1.3 ND-0.03 0.3²

0.86-1.67 3.0

0.9% area ND-0.35 0.6

0.08-0.11 0.3²

1.0 0.06-0.28 1.0

NA³ 0.12-0.17 0.3² NA = Not applicable; ND = Not detected, limit of quantitation 0.05% area; ¹Spiking and purging studies showed that the intermediate grade migalastat hydrochloride specification will be met when the impurity is present in 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside at this level; ²Controlled by the specification limit for any unspecified impurity; ³This impurity is converted to migalastat hydrochloride in Stage 3.

The structure of impurities related to those in Table 16 are shown below in Table 17.

TABLE 17 Data used for setting impurity specification limits in 5-azido-5-deoxy-1,2,3,6- tetrapivaloyl-D-galactofuranoside Structure of Potential Related Structure of Potential Related Impurities Following Stages Impurity Impurities Following Stage 3a 3b and 3c

By-products of basic and acid decomposition

Intermediate grade migalastat hydrochloride

Impurity standards used in the spiking and purging studies are set forth in Table 18.

TABLE 18 Impurity standards used for setting specification limits in 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl- D-galactofuranoside Impurity Brief description of impurity standard origin and quality

1,2,3,6-tetrapivaloyl-D-galactofuranoside is Stage 1 intermediate of the migalastat hydrochloride synthesis and was synthesized from D-(+)-galactose with a >93% w/w purity.

Compound E is a known intermediate during Stage 2 and it is not isolated during migalastat hydrochloride synthesis. It was prepared from 1,2,3,6-tetrapivaloyl-D-galactofuranoside and purified by silica gel chromatography with a 98% w/w purity.

Compound G is synthesized from 1,2,3,6-tetrapivaloyl-D- galactofuranoside and purified by silica gel chromatography with a 94% area purity.

Compound J was isolated by a preparatory HPLC from a Stage 2 batch. HPLC purity 93%.

Compound I was synthesized from the triflate Compound D and was recrystallized from heptane. The structure was established by nuclear magnetic resonance (NMR) and mass spectrum (MS) spectroscopy and its purity was determined to be 98% by HPLC.

Compound K was synthesized from the triflate Compound F and was purified by silica chromatography. Its structure was confirmed by NMR and MS spectroscopy.

Compound N was synthesized from the epi-triflate Compound F and purified by silica gel chromatography with a 97% purity.

The impurity reference standard was generated by performing preparatory HPLC method on a Stage 2 batch. The fraction corresponding to the desired peak was separated and isolated by the solvent removal. The material was confirmed by NMR and MS spectroscopy.

Example 7: Controlling Pharmaceutical Grade Migalastat Hydrochloride Impurities

Acceptable levels of impurities in intermediate grade migalastat hydrochloride were determined by spiking various impurities into Stage 4. Based on these studies, the tolerable doses of impurities set forth in Table 19 were determined. Notably, Compound U, Compound V, Compound Y, Compound W, and Compound BB were determined to impact or be linked to pharmaceutical grade migalastat hydrochloride critical quality attributes associated with drug quality.

TABLE 19 Data Used for Setting Impurity Specification Limits in Intermediate Grade Migalastat Hydrochloride Typical Maximum Levels Demon- in IG Proposed strated Migalastat Specification Tolerance HCl Limit Impurity (% w/w)¹ (% w/w) (% w/w)

0.67 ND 0.4

0.42 ND-0.13² 0.40

0.41 ND-0.1   0.25

0.15 ND-0.04  0.15

0.39 ND-0.15  0.3

0.4 ND-0.44  0.25

0.41 ND-0.09  0.15 ND =Not detected, limit of quantitation 0.05% w/w; impurities will be present as the HCl salt in intermediate grade migalastat hydrochloride; ¹From spiking and purging studies, it was shown that migalastat hydrochloride specification will be met when the impurity is present in intermediate grade migalastat hydrochloride at this level after a single Stage 4a recrystallization;

Impurity standards used in the above-mentioned studies are set forth in Table 20.

TABLE 20 Impurity standards used for setting specification limits in intermediate grade migalastat hydrochloride Impurity Brief description of impurity standard origin and quality

Stage 2 intermediate 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D- galactofuranoside was hydrogenated and then treated with sodium methoxide. The reaction mixture was chromatographed on a silica gel column. The structure of Compound U was determined by NMR spectroscopy.

Compound V was prepared by hydrogenation between migalastat hydrochloride and formaldehyde. The crude was chromatographed on a silica gel column with 97% HPLC purity. The structure was confirmed by NMR spectroscopy.

Compound Y was isolated by a preparative hydrophilic interaction liquid chromatography (HILIC) from the filtrate obtained after recrystallizing of a Stage 3 batch. The structure was confirmed by NMR and MS spectroscopy.

Compound W was prepared by hydrogenating migalastat hydrochloride in the presence of sodium methoxide. The isolated crude was recrystallized to obtain 89% pure material. The structure was confirmed by NMR spectroscopy.

Compound BB was isolated by a preparative HILIC chromatography from the filtrate obtained after recrystallizing of a Stage 3 batch. The structure was confirmed by NMR and MS spectroscopy.

Compound Z was isolated by a preparative HILIC chromatography from the filtrate obtained after recrystallizing a Stage 3 batch. The structure was confirmed by NMR and MS spectroscopy.

Compound AA was isolated by a preparative HILIC chromatography from the filtrate obtained after recrystallizing a Stage 3 batch. The structure was confirmed by NMR and MS spectroscopy.

Migalastat hydrochloride contains four stereocenters, which raise the possibility of impurities related to epimerization. Levels of four epimers were measured in batches of intermediate grade migalastat hydrochloride manufactured at the commercial scale, and the levels were less than 0.1% w/w in all batches.

Compound A, Compound EE, and Compound DD were spiked into the intermediate grade migalastat hydrochloride input to the Stage 4b recrystallization. Levels of each impurity were confirmed to be below 0.1% w/w in the migalastat hydrochloride produced.

Compound CC was spiked at 1.2% w/w into intermediate grade migalastat hydrochloride. It was found that after a single Stage 4b recrystallization, 0.7% w/w was present in the migalastat hydrochloride. Hence, assuming a consistent purge, it has been demonstrated that controlling Compound CC 0.2% w/w in intermediate grade migalastat hydrochloride will yield Compound CC at less than 0.10% w/w in the drug substance.

In view of the above, tolerable levels of diasteroisomeric impurities were determined, as set forth in Table 21.

TABLE 21 Potential Diasteroisomeric Impurities in Intermediate Grade Migalastat Hydrochloride Maximum Observed Levels in IG Demonstrated Migalastat HCl Tolerance¹ Batches n = 6 Impurity (% area) (% area)

0.2 <0.1

1.4 <0.1

0.6 <0.1

4.1 <0.1 ¹From spiking and purging studies, it was shown that migalastat hydrochloride specification will be met when the impurity is present in intermediate grade migalastat hydrochloride at this level.

Impurity standards used to evaluate diastereomer impurities are set forth in Table 22.

TABLE 22 Impurity standards used for potential diastereomer impurities in intermediate grade migalastat hydrochloride Impurity Brief description of impurity standard preparation and quality

Compound CC was purchased from Ontario Chemicals Inc. and its Certificate of Analysis (CoA) confirmed that it is 98.3% w/w pure.

Compound A was synthesized in six steps based on a literature procedure (Organic Letters 2003, Vol 5, No 14, 2527-2529). The diastereoisomer structure was confirmed by NMR spectroscopy and purity was determined to be 96.2% purity.

Compound EE was synthesized following ten step literature procedure (Carbohydrate Research, 2002, 337, 1083-1087).

Compound DD was synthesized using the Stage 2 epimeric azide impurity Compound N. The diastereoisomer structure was confirmed by NMR spectroscopy and purity was determined to be 95% by HPLC.

Example 8: Control of Genotoxins in Migalastat Hydrochloride

The starting materials, reagents, intermediates, and process impurities generated in the manufacturing process for migalastat hydrochloride were assessed for their potential genotoxicity using in silico (Derek for Windows v13 Lhasa Ltd) screening software. The chemical structures which were DEREK negative were evaluated using Leadscope (Model Applier and Expert Alerts). Materials that were identified through this process that could potentially be genotoxic are set forth below in Table 23. Where possible, the genotoxicity of these materials was then assessed via the use of the bacterial reverse mutation (Ames) test.

TABLE 23 Summary of genotoxic/potentially genotoxic impurities in migalastat hydrochloride Potential Ames Designated Genotoxin Origin Derek Positive? Positive? Genotoxin?

Non-isolated intermediate in Stage 2 Yes Insufficiently stable for Ames test Yes

Yes Insufficiently stable for Ames test Yes

Intermediate from Stage 2 Yes No No

Potential impurity formed in Stage 2 Yes No No

Potentially formed from unreacted 5-azido-5- deoxy-1,2,3,6- tetrapivaloyl-D- galactofuranoside in Stage 3 Yes Yes Yes

Yes Yes Yes

Impurity formed in Stage 3 Yes Yes Yes Ethyl chloride Potentially formed in Yes Yes Yes Methyl chloride Stages 3 and 4 Yes Yes No

Compound Q, Compound P, and Compound X were confirmed as genotoxins (Ames positive). Compound D and Compound F were not sufficiently stable for Ames testing and, therefore, were also designated as genotoxins. Impurities designated as genotoxins were screened-for using limit tests in suitable intermediates or migalastat hydrochloride drug substance itself. All the designated genotoxins were demonstrated to be below the TTC. Furthermore, confirmatory spiking experiments were completed for each of the designated genotoxins, except for Compound D and Compound F, to demonstrate that the commercial manufacturing process efficiently purges these impurities.

Compound D is transformed in Stage 2 to Compound F. Thus, levels of Compound F were monitored in batches of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside manufactured at production scale. In 15 batches of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside, Compound F was shown to be not greater than 12 mcg/g.

Levels of Compound Q and Compound P were monitored in batches of intermediate grade migalastat hydrochloride manufactured at production scale. In 11 batches of intermediate grade migalastat hydrochloride, Compound Q and Compound P were each shown to be not greater than 1.0 mcg/g.

Compound X tested positive in a bacterial reverse mutation (Ames) test. Compound X is formed from migalastat hydrochloride in Stage 3b under the harsh process conditions of heating with concentrated hydrochloride acid in the presence of sodium chloride. Levels of up to 5 mcg/g have been detected in batches of intermediate grade migalastat manufactured at production scale. Fourteen batches of intermediate grade migalastat hydrochloride drug substance were tested for levels of Compound X. 12 batches of migalastat hydrochloride drug substance derived from these 14 batches were also tested for Compound X. The results of these tests are shown in Table 24.

TABLE 24 Summary of the Test Results for Compound X in Intermediate Grade Migalastat Hydrochloride and the Corresponding Migalastat Hydrochloride Drug Substance Intermediate Grade Migalastat Subsequent Migalastat Hydrochloride Hydrochloride Compound X Compound X Batch (mcg/g) Batch (mcg/g)  1 NGT 12¹ A NGT 1.0   2 NGT 12¹  3 NGT 12¹ B 1.4   4² NGT 12¹ C NGT 1.0   5 NGT 12¹ D NGT 1.0   6 NGT 12¹ E NGT 1.0  F NGT 1.0³  7 NGT 12¹ G NGT 1.0³  8 NGT 1.0  H NGT 1.0   9 NGT 2.2  I NGT 1.0⁴ 10 4.8 J NGT 1.0⁴ 11 NGT 2.2  K NGT 1.0⁴ 12 2.2 L NGT 1.0⁴ 13 NGT 2.2  14 NGT 2.2  NGT = Not greater than; ¹Data generated using a developmental method run as a limit test at 12 mcg/g; ²Material was reprocessed; ³Data generated on output from Stage 4a Batches F and G; ⁴Analysis run as a 4.0 mcg/g limit test with adequate sensitivity at 1 mcg/g demonstrated.

The tests demonstrated that levels of Compound X in drug substance are not greater than 2 mcg/g for all batches tested. Based on the Threshold of Toxicological Concern (TTC) of less than 1.5 mcg/day for the migalastat therapeutic dose of 123 mg/day, the control limit for Compound X is 12 mcg/g.

Analytical procedures used to determine various genotoxic impurities are set forth in Table 25.

TABLE 25 Summary of Analytical Procedures and Validation Data for Genotoxic Impurities Method Analytical Method Validation Impurity Origin Material Tested Technique Summary Summary Compound F Non-isolated 5-azido-5-deoxy- NMR Compound Specificity: No intermediate in 1,2,3,6- F Limit Test significant Stage 2 tetrapivaloyl-D- by ¹⁹F NMR interferences galactofuranoside Spectroscopy from blank or sample peaks Detection Limit of 12 μg/g with acceptable signal-to-noise ratio for standard Accuracy: Acceptable recovery (>95%) Compound Q Potentially formed IG migalastat LC-MS Gradient Specificity: No Compound P from unreacted 5- hydrochloride reversed- significant azido-5-deoxy- and migalastat phase HPLC interferences 1,2,3,6- hydrochloride using from blank or tetrapivaloyl-D- drug substance Hypercarb sample peaks galactofuranoside column with Accuracy: in Stage 3 MS SIM Acceptable detection at recovery 204 Da (>95%) Signal-to-noise ratio for standard at 1.0 μg/g >10 Compound X Impurity formed IG migalastat LC-MS- Compound Compound X in Stage 3 hydrochloride MS X Limit Limit Test by and migalastat Test by HPLC-MS-MS hydrochloride HPLC-MS- drug substance MS

Example 9: Identification of Important Parameters—Stage 2

Parameters impacting the quality of the final drug product were evaluated through experimentation and consideration of batch data to determine critical process parameters and identify parameter ranges.

A series of univariate and multivariate experiments were performed to identify ranges for parameters in the Stage 2 chemical reactions. The development of these ranges focused on ensuring that conversion to each intermediate was appropriate and that the yield of 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside was consistent.

In addition, residual DMSO in 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside was identified as impacting the formation of Compound Y in Stage 3a by acting as a poison for the palladium on carbon catalyst. A series of spiking experiments were performed to confirm that the level of DMSO in 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is related to levels of Compound Y. Data (not shown) demonstrate that higher levels of DMSO in 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside will lead to higher levels of Compound Y in migalastat hydrochloride. For this reason, the level of DMSO present in isolated 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside was controlled to below 0.01% w/w in 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside.

Conditions impacting the removal of DMSO from the isolated 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside were investigated. For example, in a multi-factorial experiment, summarized in Table 26, the effectiveness of the methanol wash at removing the DMSO from the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside filter cake was investigated. In this experiment, after washing the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside was dried under vacuum.

TABLE 26 Parameters studied in the Stage 2 washing study Range Parameter Studied Output Studied Wash −10-10° C. Levels of DMSO in 5-azido-5-deoxy- temperature 1,2,3,6-tetrapivaloyl-D- Methanol 1-3 volumes galactofuranoside volumes Wash time 5-15 minutes

Levels of DMSO were controlled to below the specification limit 0.01% w/w in the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside produced in each of the experiments. In addition, the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside produced was converted to intermediate grade migalastat hydrochloride in each and consistent quality was observed in the quality of the material produced. Thus, the combination of the methanol wash and subsequent drying resulted in sufficient control of the DMSO.

Example 10: Identification of Critical Process Parameters—Stage 3a

Parameters impacting critical quality attributes were evaluated through experimentation and consideration of batch data to determine critical process parameters and identify parameter ranges.

Control of Compound W

It was established that there was a potential risk of formation of increased levels of the critical quality attribute (CQA) Compound W through oxidation in the presence of the palladium on carbon catalyst (FIG. 7 ). Compound W does not purge in the Stage 4 recrystallization. An alteration in the order of the unit operations in Stage 3a was implemented to mitigate this risk and improve control of Compound W. Earlier filtration of the palladium on carbon catalyst suppresses formation of Compound W and this modification was therefore introduced into the commercial process to provide additional process robustness. FIG. 8 illustrates the commercial process with the catalyst removed at the end of Stage 3a. This is exemplified by the data summarized in Table 27, which shows levels of Compound W from a direct comparison experiment. Compound W was present at 0.6% area in intermediate grade migalastat hydrochloride following manufacture via the process in which the palladium catalyst is present at Stage 3b. In contrast, Compound W was not detected in intermediate grade migalastat hydrochloride produced via the process in which the palladium catalyst is removed before Stage 3b.

TABLE 27 Levels of Compound W in Intermediate Grade Migalastat Hydrochloride Produced via Laboratory Scale Clinical/Stability and Commercial Processes Compound W Process (% w/w) Pd catalyst present in Stage 3b 0.62 Pd catalyst removed before Stage 3b None detected Control of Compound U, Compound V, Compound BB, and Compound Y

In Stage 3a, Compound U is formed as a result of incomplete reduction of the intermediate Compound T (see FIG. 9 ). Compound Y, Compound BB, and Compound V are formed from by-products of Stage 3a.

In Stage 3a, 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside is reduced quickly to the first intermediate Compound R. Compound R is then transformed in a slower process via Compound T to the intermediate Compound S. The extent of the Stage 3a reduction is related to the reaction time, and time was identified as a CPP for the control of Compound U derived from residual Compound R and Compound T.

A detailed risk assessment of Stage 3a was undertaken. Through this process, additional parameters in Stage 3a were identified as potentially impacting the drug-related impurity CQAs Compound Y, Compound U, Compound BB, and Compound V. These parameters were then investigated in a series of multifactorial experiments.

A fractional factorial design was performed to identify process parameters and interactions in Stage 3a which had the greatest impact on Compound Y, Compound U, Compound BB, and Compound V. Table 28 shows the parameters and the corresponding ranges that were investigated.

Each reaction was run for 44 hours and the pivaloyl protecting groups were removed under the Stage 3b conditions. The crude reaction mixture was then analyzed prior to Stage 3c, so levels of the impurities were higher than those which would be seen in intermediate grade migalastat hydrochloride after purging during the crystallization.

TABLE 28 Potential CPPs and ranges studied in Stage 3a DOEs Parameter Range Studied Output studied Temperature 35-55° C. Levels of Compound Y, Palladium catalyst quantity 0.5-2.5 mol % Compound U, Methanol volumes 6-10 volumes Compound BB, and Hydrogen pressure 6 to 10 bar gauge Compound V (5-9 bar absolute) Parameters Impacting Compound V

The findings for Compound V from the fractional factorial design are summarized by the half-normal effects plot in FIG. 10 . The effects in the fitted model are indicated by a letter on the graph (effects included are all those statistically significant with p<0.05 unless otherwise stated, or included to support hierarchy for a higher order). These half-normal plots are used to identify the effect of individual parameters and interactions between parameters on the CQAs within the ranges investigated in the design. Some parameters have a greater impact on the attribute, indicated by the higher numerical x-axis value on the graph, i.e., they appear further to the right hand side of the half-normal plot. FIG. 10 illustrates that the amount of Compound V formed was impacted primarily by the palladium catalyst quantity. The fractional factorial design indicated that an increased quantity of palladium on carbon catalyst and increased methanol volumes led to increased levels of Compound V. These data also indicated that there was an interaction between these two parameters. There was also a temperature effect on Compound V alongside its interaction with methanol volumes.

The impact of palladium catalyst quantity on levels of Compound V is exemplified by the effects plot in FIG. 11 which illustrates the effect on Compound V of the palladium catalyst quantity. Error bars represent least significant differences (LSD) at 95% confidence levels. If the response ranges indicated by the LSD bars for two points do not overlap, the points are statistically different. Experimental values run in the design are represented on the effect plot as circles. The specific effect plot is conditional on the level of factors not explicitly displayed (the conditional levels are listed as text to the left of the graphics with a label “Actual Factors”), hence, demonstrating the size of the relationship and not the precise location. Effect plots such as FIG. 11 are used to visualize the predicted relationship between the parameter on the x-axis and the response on the y-axis.

In another study outside the multifactorial experiments, the impact of extended reaction time on Compound V was also investigated. In a single univariate experiment, the Stage 3a reaction was allowed to continue for up to 92 hours prior to removal of the catalyst. Levels of Compound V were higher than typically observed. Palladium catalyst quantity, time, and methanol volumes were therefore identified as CPPs impacting Compound V in Stage 3a.

Parameters Impacting Compound U

From the same fractional factorial design, parameters influencing Compound U were also established. The relative impact of the parameters is again illustrated by the half-normal effects plot in FIG. 12 , which shows that levels are increased by reducing the palladium catalyst quantity. In several of the design runs, Compound U was not detected in the output. The temperature of the reaction has a similar impact, with lower temperatures leading to increased levels.

There was also an interaction between temperature and the palladium catalyst quantity, which is illustrated by the interaction plot in FIG. 13 , which shows that decreasing the quantity of catalyst leads to increased Compound U. The interaction plots are used to visualize the predicted relationship between the factor (on the x-axis) and the response (on the y-axis) and interactions are displayed through two lines appearing within the plot, where the colored square and triangle symbols on the line represent distinct levels of the second parameter in the interaction.

Overall, Compound U is increased most severely when both temperature and palladium catalyst quantity are low. If either of the parameters is maintained at the upper end of the range, the severity is greatly reduced. Palladium catalyst quantity and temperature were therefore identified as CPPs for the control of Compound U in Stage 3a.

The pressure in Stage 3a did not impact levels of Compound U across the range of 6-10 barg studied. In an additional experiment when Stage 3a was performed at the lower pressure of 4 barg, the rate of reaction was significantly slower and levels of Compound U were increased. For this reason, pressure was also identified as a CPP.

Parameters Impacting Compound Y

From the same fractional factorial design, parameters influencing levels of Compound Y were also established. The same parameters which impacted levels of Compound U demonstrated a similar effect on levels of Compound Y, which was most impacted by the palladium catalyst quantity. Overall, where the palladium catalyst quantity was high, Compound Y was undetected in the intermediate grade migalastat hydrochloride. Palladium catalyst quantity and temperature were therefore also shown to be CPPs for the control of Compound Y in Stage 3a. In an additional experiment when Stage 3a was performed at 4 barg, levels of Compound Y were increased. For this reason, pressure was also identified as a CPP impacting Compound Y.

Establishing Ranges for CPPs and Confirming Robustness in Stage 3a

In order to identify operating ranges for the CPPs identified in Stage 3a, a robustness fractional factorial design was carried out. A robustness fractional factorial design was used to show that the process can be operated anywhere within the ranges defined for the CPPs and includes those combinations of parameter setpoints designed to increase impurities to their highest potential levels.

Details of this experiment are summarized in Table 29. Temperature, hydrogen pressure, palladium catalyst quantity, and methanol volumes were included as parameters, and the output was processed through Stages 3b and 3c under standard conditions. All experiments were run for 44 hours and levels of the impurities were measured in the intermediate grade migalastat hydrochloride produced.

TABLE 29 CPPs and ranges studied in Stage 3a robustness design Parameter Range Studied Output studied Temperature 40-50° C. Levels of Compound U, Hydrogen pressure 7-9 barg Compound Y, Compound BB, (8-10 bar abs) and Compound V in Palladium catalyst 0.07-0.013 equiv intermediate grade migalastat quantity hydrochloride Methanol volumes 7-9 volumes

Material from all of the experiments met the specification for drug-related impurity CQAs in intermediate grade migalastat hydrochloride. The fractional factorial design, therefore, confirmed that the ranges in Table 29 are appropriate. In addition, the experiment confirmed that a time of 44 hours or more was an appropriate minimum range.

Palladium catalyst quantity, methanol volumes, and time are CPPs for the control of Compound V, and levels increase with extended time. A maximum time was established in a separate univariate experiment. Table 30 shows the levels of the CPPs for this experiment. The pressure was set at 8 barg and the temperature at 45° C.

TABLE 30 Experiment to define a maximum time for Stage 3a CPP Setpoint Output studied Palladium catalyst quantity 0.013 equiv Levels of Compound V Time for Stage 3a 68 hours Methanol volumes 9 volumes

Levels of Compound V in the intermediate grade migalastat hydrochloride were within specification and a maximum time of 68 hours was therefore defined.

Impact of Scale and Equipment on Stage 3a

Heterogeneous hydrogenation processes can be sensitive to vessel configuration and impeller speed, which strongly influence the gas/liquid mass transfer properties of the system. For this reason, the design of these reactors usually includes a high speed turbine impeller positioned low in the vessel. In addition, the impeller shafts may be ‘gas entrainment’ type, i.e., shaft of hollow construction with apertures at the top and bottom extremities which cause gas to be drawn down from the head-space and expelled via the turbine into the liquid vortex causing maximum dispersion and gas transfer.

A series of experiments was conducted to explore the impact of extremes of hydrogen pressure, impeller speed, vessel fill, and gas entrainment on Stage 3a hydrogenation reaction conversion and the profile of isolated intermediate grade migalastat hydrochloride. These experiments are summarized in Table 31.

TABLE 31 Summary of experimental runs and operating conditions Parameter Run 1 Run 2 Run 3 Run 4 Run 5 5-azido-5-deoxy-1,2,3,6- 50 g 20 g 20 g 20 g 20 g tetrapivaloyl-D- galactofuranoside (scale) Volumes of MeOH (scale) 8 vol 8 vol 8 vol 8 vol 8 vol Temperature 45° C. 45° C. 45° C. 45° C. 45° C. Pressure/barg 4 4 8.5 8.5 8.5 Vessel fill level¹ 80% 32% 32% 32% 32% Agitation setpoint 50 50 50 750 750 rpm rpm rpm rpm rpm² ¹Calculated with respect to the nominal vessel capacity (0.5 L); ²Gas entrainment blocked for this run only.

In run 1, even under the conditions of low pressure, low stirrer speed, and high fill level, the rate of reaction (data not shown) was comparable to that of run 4, where conditions for these three parameters were reversed.

In a further assessment of the scalability, FIG. 14 shows the reaction profile for Stage 3a in a 70 g laboratory scale experiment, at 0.8 kg (20 liter) scale and at 31 kg production scale.

Zero hours was defined as the time following completion of the venting to release the nitrogen generated during reduction of the 5-azido-5-deoxy-1,2,3,6-tetrapivaloyl-D-galactofuranoside to Compound R. Each of the batches met the reaction endpoint after an equivalent amount of time, and the overall reaction profile at the three scales was comparable. Notably, the plant scale hydrogenator outperformed the lab scale equipment.

Example 11: Identification of Critical Process Parameters—Stages 3b and 3c

Control of Residue on Ignition in Stage 3b

Residue on ignition is a CQA and a measure of inorganic impurity levels. Sodium chloride is an inorganic by-product impurity of Stage 3b that is detected in intermediate grade migalastat hydrochloride. No further inorganic impurities are introduced after this Stage, and the residue on ignition of drug substance is impacted by the levels of sodium chloride in intermediate grade migalastat hydrochloride. Sodium chloride is formed following the addition of 37% hydrochloric acid to the concentrated mixture of migalastat free base and sodium alkoxides. The sodium chloride, which has only partial solubility in the 37% hydrochloric acid solution of migalastat, is then mostly removed by filtration.

The Stage 3b process is shown in greater detail in FIG. 15 . Following addition of the 37% hydrochloric acid, the mixture is heated for an age time to ensure that the migalastat hydrochloride is in solution and the sodium chloride has precipitated prior to the filtration. The mixture is then cooled and the sodium chloride filtered, prior to crystallization in Stage 3c. FIG. 16 is a schematic of the Stage 3b process, showing how the temperature is varied after the addition of the 37% hydrochloric acid.

An investigation of the parameters potentially impacting the removal of sodium chloride in Stage 3b was undertaken. The objective of this investigation was to establish a robust control strategy to ensure that the residue on ignition would always meet the 7% w/w specification limit in intermediate grade migalastat hydrochloride.

Two multifactorial studies were run, investigating the parameters identified as potentially impacting the removal of sodium chloride in the filtration in Stage 3b. The first multifactorial study focused on investigating the potential link between the solution composition and the addition of hydrochloric acid. The conditions evaluated in this are summarized in Table 32. Other parameters in the process were held constant during this study and intermediate grade migalastat hydrochloride was analyzed after isolation under the standard conditions for Stage 3c.

TABLE 32 Parameters and ranges studied in first Stage 3b study Parameter Range studied Output studied 30% Sodium methoxide 0.8-1.2 equiv Residue on ignition of quantity intermediate grade HCl addition time 30-150 minutes migalastat HCl addition temperature 20-50° C. hydrochloride¹ 37% HCl quantity 2.75-3.25 vol Hold time after addition 0-120 min Heat up time to age 10-110 min temperature Residual weight after 0.5-0.9 weights distillation/methanol quantity ¹Determined via sodium assay.

All of the intermediate grade migalastat hydrochloride produced met the specification for residue on ignition, with levels ranging from 1.2% to 2.1% w/w.

The second multifactorial study focused on investigating the potential link between the solution composition and the age process. The conditions evaluated are summarized in Table 33. Again, intermediate grade migalastat hydrochloride was analyzed after isolation under the standard conditions for Stage 3c.

TABLE 33 Parameters and ranges studied in second Stage 3b study Parameter Range studied Output studied 30% Sodium methoxide 0.8-1.2 equiv Residue on ignition of quantity intermediate grade Age time 1-10 hrs migalastat Age temperature 40-55° C. hydrochloride¹ 37% HCl quantity 2.75-3.25 vol Age time prior to filtration 30-120 min Filtration temperature 25-40° C. Residual weight after 0.5-0.9 weights distillation/methanol quantity ¹Determined via sodium assay.

Material from all of the experiments met the specification for residue on ignition in intermediate grade migalastat hydrochloride, with levels ranging from 1.0% to 2.5% w/w. However, the data indicated that the residue on ignition was influenced by the filtration temperature, with higher temperatures leading to higher levels of residue on ignition. The significance of the filtration temperature is illustrated in the half normal plot FIG. 17 .

To verify this finding, the solubility of sodium chloride in the reaction mixture of 37% hydrochloric acid and methanol was measured across a range of temperatures. This solubility data is shown in the chart in FIG. 18 .

This trend was also confirmed in a univariate experiment where Stage 3b was filtered at 60° C., resulting in a residue on ignition in intermediate grade migalastat hydrochloride of 4.6% w/w. On the basis of these results, the filtration temperature was defined as a CPP for the control of residue on ignition.

It was also shown that the concentration of the 37% hydrochloric acid has an impact, with lower acid concentrations leading to greater solubility of sodium chloride, and therefore, higher residue on ignition. This was confirmed in an experiment where 32% hydrochloric acid was used which led to a residue on ignition in intermediate grade migalastat hydrochloride of 5.2% w/w. For this reason, the concentration of hydrochloric acid was controlled to within the range 35%-37% by the specification.

Control of Compound X in Stage 3b

Compound X is a genotoxic impurity which can form in Stage 3, as shown in FIG. 19 . Compound X was well controlled in batches of drug substance, being not greater than 2.0 mcg/g, well below the threshold of toxicological concern (TTC) of 12 mcg/g. Compound X can form under the harsh process conditions in Stage 3b where the solution of migalastat hydrochloride in concentrated hydrochloric acid is aged at elevated temperature in a solution saturated with sodium chloride.

Parameters potentially impacting Compound X were all included within a multifactorial study. The intermediate grade migalastat hydrochloride produced in this study, details of which are reproduced in Table 34, was analyzed to determine levels of Compound X.

TABLE 34 Parameters and Ranges Studied to Determine the Impact on Compound X Parameter Range Studied Output Studied 30% Sodium methoxide quantity 0.8-1.2 equiv Levels of Age time 1-10 hrs Compound X Age temperature 40-55° C. in intermediate 37% HCl quantity 2.75-3.25 vol grade migalastat Age time prior to filtration 30-120 min hydrochloride Filtration temperature 25-40° C. Residual weight after 0.5-0.9 weights distillation/methanol quantity

Levels of Compound X between 2 and 21 mcg/g were detected in the intermediate grade migalastat hydrochloride produced. FIG. 20 illustrates the impact of the parameters studied. Higher levels of Compound X were commonly observed when the residual weight after the distillation was low, the age time was long, or the age temperature was higher. Age time, age temperature, and residual weight after the distillation were therefore concluded to be CPPs for the control of Compound X.

The intermediate grade migalastat hydrochloride containing 21 mcg/g of Compound X was recrystallized via the Stage 4 process and the migalastat hydrochloride produced had Compound X at not greater than 3 mcg/g.

Purging of Drug-Related Impurity CQAs in Stages 3b and 3c

Some drug-related impurity CQAs are partially purged in the isolation of intermediate grade migalastat hydrochloride. Thus, conditions in Stages 3b and 3c could potentially impact the purging of drug-related impurity CQAs (FIG. 21 ) and a series of scoping experiments were performed to establish which impurities were influenced. Those drug-related impurity CQAs which are partially purged in the isolation of intermediate grade migalastat hydrochloride in Stages 3b and 3c are shown in Table 35.

TABLE 35 CQA Impurities Partially Purged by the Stage 3c Crystallization of Intermediate Grade Migalastat Hydrochloride

Following the scoping experiments, potential CPPs which might impact the purging of the drug-related impurity CQAs were identified through a further risk assessment. These parameters were then studied in a fractional factorial design to determine their criticality and establish ranges. No assessment of the impact upon Compound BB could be made in this study since levels were uniformly below the limit of detection.

TABLE 36 Parameters studied following risk assessment Range Stage Parameter Studied Output Studied 3b 37% HCl quantity 2.7-3.7 vol Levels of Compound 3c Temperature 15-25° C. Y, Compound V, Time/rate for ethanol addition 12-50 min and Compound U in Volume of ethanol added 6.5-8.5 vol intermediate grade Age time 1-5 hours migalastat hydrochloride

The results from the experiments showed that levels of Compound U were impacted by the ethanol addition time and the temperature during Stage 3c. FIG. 22 is a half-normal plot generated using data from this study. It illustrates that decreasing the time of the ethanol addition or decreasing the temperature will lead to higher levels of Compound U in the intermediate grade migalastat hydrochloride. This point is further illustrated in the effects plot in FIG. 23 , which illustrates that decreasing the temperature will reduce the degree of purging and hence, increase the level of Compound U in the intermediate grade migalastat hydrochloride.

A similar trend plot was obtained for the rate/time of ethanol addition, showing that faster rate will lead to less purging of Compound U. Hence, a decrease in the time for ethanol addition will lead to higher levels of Compound U. The time of ethanol addition and the isolation temperature were therefore identified as CPPs in Stage 3c.

Similar data was obtained for Compound Y showing that purging of this CQA was also impacted in the same way by the CPPs. Data for Compound V, however, suggested that no parameter had a significant impact on its purging.

For the related impurity CQA Compound BB, a separate study was performed to determine whether the same parameters could impact its purging. Two experiments were run varying the temperature and time for the ethanol addition, as summarized in Table 37.

TABLE 37 Parameters studied following risk assessment Range Stage Parameter Studied Output Studied 3c Temperature 17 and 45° C. Levels of Compoun BB in Time/rate for 5 and 60 min intermediate grade ethanol addition migalastat Time/rate for ethanol addition 5 and 60 min hydrochloride

At the lower temperature and shorter addition time, Compound BB was observed at 0.5% w/w in the intermediate grade migalastat hydrochloride. When the temperature was higher and the addition time longer, Compound BB was present at 0.2% w/w. These two parameters are therefore also CPPs for the control of the Compound BB.

In summary, two CPPs were identified for the control of the purging of the drug-related impurity CQAs in Stages 3b and 3c. Shorter times for the ethanol addition and lower temperatures will lead to increased levels of Compound U, Compound Y, and Compound BB in intermediate grade migalastat hydrochloride.

Since longer addition times and higher temperatures will lead to reduced levels of the related impurity CQAs, the ranges for these CPPs were defined by one extreme of the ranges in Table 36 and limited to not less than 15° C. and not less than 30 minutes, respectively.

Conclusions: CPPs in Stage 3

Following completion of the evaluating activities for Stage 3, the risk assessment was updated to incorporate data from batches manufactured at commercial scale. The CPPs for control of related impurity CQAs in Stage 3a include temperature, the catalyst quantity, hydrogen pressure, methanol volumes, and time. The CPP for control of residue on ignition in Stage 3b includes filtration temperature. The CPPs for control of the genotoxin Compound X in Stage 3b include the residual weight after the distillation, age time, and age temperature. The CPPs which impact the purging of related impurity CQAs in Stages 3b and 3c include the temperature and time for ethanol addition. These CPPs and their corresponding ranges for Stage 3 are listed in Table 38.

TABLE 38 CPPs in Stage 3 Range Other Known Stage Parameter Studied CQA Impacted Attributes Impacted 3a Palladium 0.007- Compound U — catalyst 0.013 Compound Y quantity equivalents Compound V Time 44-68 hours Temperature 40-50° C. Hydrogen 8-10 bar pressure (abs) Methanol 7-9 volumes volumes 3b Filtration 25-40° C. Residue on — temperature ignition Residual NLT 0.5 — Compound X weight after weights distillation Age time NMT 10 hours Age 40-55° C. temperature 3c Time for NLT 30 Compound U — ethanol minutes Compound Y addition Compound BB Temperature NLT 15° C. NLT = Not less than; NMT = Not more than

Example 12: Preparation of Migalastat Hydrochloride

Intermediate grade migalastat hydrochloride was recrystallized twice from a mixture of water and ethanol to give migalastat hydrochloride. The two recrystallization steps are represented as Stage 4a and Stage 4b in the manufacturing process. The main difference between Stage 4a and Stage 4b was the hold time during the ethanol addition in Stage 4b. In Stage 4a, intermediate grade migalastat hydrochloride was dissolved in water by warming to the crystallization temperature. Ethanol was added as an anti-solvent to induce crystallization and the slurry was cooled to the isolation temperature. The migalastat hydrochloride was filtered, washed with ethanol, and dried. In Stage 4b, following the dissolution in water, the solution was clarified. The solution was adjusted to the crystallization temperature and ethanol (ethanol 1 quantity) was added to induce crystallization. Following a hold time, the remainder of the ethanol (ethanol 2 quantity) was added before the slurry was cooled to the isolation temperature. The migalastat hydrochloride was filtered, washed with ethanol, and dried.

Each of the Stage 4 unit operations and process parameters were assessed for their potential impact on the CQAs of migalastat hydrochloride.

Identification of CPPs Impacting the Control of Sodium Chloride

Parameters in the Stage 4 process were assessed for their potential to influence the solubility of sodium chloride, which is soluble in aqueous ethanol mixtures. Table 39 summarizes parameters identified as having the potential to impact the solubility of sodium chloride in both Stage 4a and Stage 4b. The range studied for each parameter is also given. These were defined with reference to solubility data for sodium chloride as well as solubility and metastable limit data for migalastat hydrochloride.

TABLE 39 CPPs in Stage 3 Setpoint/ CQA Parameter Unit Target Range Impacted Total water quantity Weights 1.3 1.0-1.6 Residue on Total ethanol quantity¹ Weights 9.5  4.8-11.4 ignition Isolation temperature ° C. 20  5-35 ¹The Stage 4a parameter of ethanol quantity was equivalent to the sum of the Stage 4b parameters of ethanol 1 quantity and ethanol 2 quantity.

FIG. 25 shows the impact of total quantities of water and ethanol on the relative concentration of sodium chloride solubilized in the crystallization mixture. This shows that a change in the total water quantity between 1.1 and 1.4 weights has a large impact on the concentration of sodium chloride. For this reason, total water quantities in Stage 4a and Stage 4b were assessed to be CPPs for the control of residue on ignition. FIG. 25 also shows that a change in the total ethanol quantity between 8.5 and 10.5 has a smaller impact on the concentration of sodium chloride.

Based on this data, the ranges of from 1.1-1.4 weights were selected for purging of a minimum residue on ignition of 3.5% w/w in each crystallization. This caused the intermediate grade migalastat hydrochloride residue on ignition specification of 7% w/w to be purged in Stages 4a and 4b.

Control of Residual Ethanol in Migalastat Hydrochloride

Ethanol was the main solvent used in the final stage of manufacture and a CQA of migalastat hydrochloride. Low levels of ethanol are generally observed in batches of migalastat hydrochloride. Parameters in the Stage 4b process were assessed for their potential to influence the ethanol content. Table 40 summarizes those parameters identified as having the potential to impact the ethanol content in Stage 4b. The range studied for each parameter is also given. These were set with reference to solubility and metastable limit data for migalastat hydrochloride.

TABLE 40 Parameters and Ranges Assessed for the Control of Ethanol Content Setpoint/ CQA Parameter Unit Target Range Impacted Total water quantity Weights 1.3 1.0-1.6 Ethanol Ethanol quantity¹ Weights 1.9  1.0-11.4 content Ethanol addition time¹ Minutes 60  0-65 Ethanol addition temperature¹ ° C. 50 30-60 Agitation speed Rpm NA  300-1150 NA = Not applicable; ¹Prior to introduction of a hold time, the ethanol quantity was considered as a single portion

It was demonstrated that the levels of ethanol are strongly impacted by the level of supersaturation at the point of nucleation. In order to control the supersaturation in Stage 4b, a hold time during the addition of ethanol was introduced. Table 41 shows the results of two experiments, both using rapid ethanol addition to generate high supersaturation. In the first experiment, 6 volumes of ethanol were added over 2.5 minutes. This was equivalent to addition of the total ethanol quantity in 5 minutes. In the second experiment, when a 5-minute hold time was incorporated after the addition of the first 1.3 volumes, levels of ethanol were reduced.

TABLE 41 Impact of Hold Time in Stage 4b Process on Ethanol Content Ethanol Ethanol Addition 5 min Hold Time Content Rate During Ethanol (% Details (vols/min) Addition Utilized w/w)^(1, 2) Rapid ethanol addition 2.4 No 0.5 without hold time Rapid ethanol addition split 2.4 Yes 0.2 into 2 portions separated by a 5 min hold time ¹Drug substance specification for ethanol content is not greater than 0.5% w/w; ²Migalastat hydrochloride was dried in vacuo to constant weight.

As a result of these data, the hold time, which limited the maximum level of supersaturation, and the ethanol 1 addition time were assessed to be CPPs for the control of ethanol. The parameters of water quantity, ethanol 1 quantity, and ethanol 1 addition temperature were assessed to be CPPs for the control of ethanol content, because the solubility and hence, the level of supersaturation during the crystallization, is strongly impacted by these parameters.

Identification of CPPs and Corresponding Ranges for Control of Ethanol Content

Water quantity, ethanol 1 quantity, ethanol 1 addition temperature, ethanol 1 addition time, and hold time were identified as CPPs for the control of ethanol in Stage 4b as a result of their impact on the supersaturation and nucleation of the system. Table 42 summarizes the ranges that were selected to allow crystallization in Stage 4b whilst preventing high levels of supersaturation. Ranges for water quantity, ethanol 1 quantity, and ethanol 1 addition temperature were defined based on dissolution solubility and metastable limit data. Ranges for ethanol 1 addition time and hold time were defined based on experimental data.

TABLE 42 CPPs and Ranges Impacting the Control of Ethanol in Stage 4 Stage CPP Range CQA Impacted 4b Water quantity 1.1-1.4 weights Ethanol content Ethanol 1 quantity 1.8-2.0 weights Ethanol 1 addition temperature 40-60° C. Ethanol 1 addition time NLT 5 minutes Hold time NLT 5 minutes NLT = Not less than Assessment of the Impact of Stage 4 Parameters on the Purging of CQA Impurities

Table 43 shows which of the related impurity CQAs are impacted by Stage 4. Each of these impurities is partially purged in both the Stage 4a and Stage 4b recrystallizations. The genotoxic impurity, Compound X, was demonstrated to be partially purged via the Stage 4 process.

TABLE 43 CQA Impurities Partially Purged in Stage 4

Summary of CQAs Impacted by Stage 4

It was established that the CQA of residue on ignition is controlled in Stages 4a and 4b. The CQA of ethanol is controlled in Stage 4b and the CQAs impurities Compound U, Compound V, Compound Y, and Compound BB are partially purged in both Stage 4a and Stage 4b.

Robustness of the Stage 4a Process

To confirm that the ranges selected for parameters in Stage 4a were appropriate, a fractional factorial study was carried out. Intermediate grade migalastat hydrochloride was used as input. The input residue on ignition was 7% w/w and drug-related impurity CQAs were present at typical levels. In addition to the CPP of water quantity, the parameters of ethanol quantity and isolation temperature, assessed to have an impact on the residue of ignition, were included in the study. Table 44 summarizes the parameters, ranges, and CQAs investigated.

TABLE 44 Parameters and Ranges Selected for the Stage 4a Robustness Study Parameter¹ Range Studied Output Studied Water quantity 1.1-1.4 weights Levels of residue on ignition², Ethanol quantity 8.4-10.6 weights Compound U, Compound W, Isolation 5-35° C. Compound V, Compound Y, temperature and Compound BB ¹CPPs are highlighted in bold text; ²Determined via sodium assay using HILIC/CAD.

Levels of sodium for all the experiments were reduced, with the level removed ranging from 54% to 100%. The highest remaining levels were equal to a residue on ignition of 3.3% w/w. As a minimum residue of ignition of 3.5% w/w is also purged in Stage 4b, this design demonstrated that the identified ranges were appropriate for the control of residue on ignition in Stage 4a. Water quantity was identified as impacting the level of residue on ignition in the design. This confirmed the assessment of water quantity as a CPP and demonstrated that there was no impact of, or interactions with, the other parameters studied. In addition, levels of all drug-related impurity CQAs from the experiments were below the drug substance specification of 0.15% w/w.

Robustness of the Stage 4b Process

A fractional factorial study was carried out to confirm the ranges selected for Stage 4b. Intermediate grade migalastat hydrochloride was used as input. The input residue on ignition was 0.83% w/w and drug-related impurity CQAs were present at typical levels. In addition to the CPPs identified for this stage, other parameters, assessed to have an impact on the CQAs of residual ethanol and residue on ignition, were included in the study. Table 45 summarizes the parameters, ranges, and CQAs investigated.

TABLE 45 Parameters and Ranges Selected for the Stage 4b Robustness Study Parameter¹ Range Studied Output Studied² Input quantity of IG 0.97-1.03 equivalents Levels of residue on migalastat hydrochloride ignition, ethanol content, Water quantity 1.1-1.4 weights Compound U, Ethanol 1 addition 40-60° C. Compound W, temperature Compound V, Ethanol 1 quantity 1.8-2.0 weights Compound Y, Ethanol 1 addition time 5-60 minutes and Compound BB Hold time 5-60 minutes Ethanol 2 quantity 6.7-8.4 weights Ethanol 2 addition time 15-60 minutes Isolation temperature 5-35° C. ¹CPPs are highlighted in bold text; ²Levels of water were also determined as an output from this study. Levels were <0.10% w/w in all cases.

Material from all the experiments contained levels of residue on ignition at <0.10% w/w, less than the drug substance specification limit of 0.20% w/w. Levels of ethanol ranged from 0.03% to 0.24% w/w, less than the specification limit of 0.5% w/w. In addition, levels of all drug-related impurity CQAs from the experiments were below the drug substance specification of 0.15% w/w.

These studies demonstrated that the investigated ranges were appropriate for the control of residue on ignition and ethanol content in Stage 4. The studies also demonstrated the drug substance specification for CQA impurities was met with a single recrystallization, using typical intermediate grade migalastat hydrochloride as input.

Conclusions: CPPs Identified for Stage 4

The CPPs and the corresponding ranges for Stage 4 are listed in Table 46. A further series of experiments verified the ranges for Stage 4a and Stage 4b and also the impact of including intermediate grade migalastat hydrochloride at the specification limit for CQA impurities and residue on ignition.

TABLE 46 CPPs in Stage 4 Stage CPP Range CQA Impacted 4a Water quantity 1.1-1.4 weights Residue on ignition Water quantity 1.1-1.4 weights Ethanol, residue on ignition 4b Ethanol 1 quantity 1.8-2.0 weights Ethanol Ethanol 1 addition 40-60° C. temperature Ethanol 1 addition time NLT 5 minutes Hold time NLT 5 minutes NLT = Not less than Summary of CPPs and Corresponding Ranges for the Manufacture of Migalastat Hydrochloride

Following completion of the development activities to identify CPPs and appropriate ranges, the risk assessment was updated with the information that had been generated. Those parameters established as impacting upon CQAs were reassessed for the severity of that impact and were then categorized as CPPs or PPs. The CPPs and their corresponding ranges for the manufacturing process for migalastat hydrochloride drug substance are listed in Table 47.

TABLE 47 CPPs and Corresponding Ranges for the Manufacture of Migalastat Hydrochloride Other Known CQA Attributes Stage CPP Range Unit Impacted Impacted 3a Palladium catalyst quantity 0.007- Molar Compound U — 0.013 equivalents Compound Y Time 44-68 Hours Compound V Temperature 40-50 ° C. Hydrogen pressure 8-10 Bar (abs) Methanol volumes 7-9 Volumes 3b Residual weight after NLT 0.5 Weights — Compound X distillation Age time NMT 10 Hours Age temperature 40-55 ° C. Filtration temperature 25-40 ° C. Residue on — ignition 3c Time for ethanol NLT 30 Minutes Compound U — addition Compound Y Temperature NLT 15 ° C. Compound BB 4a Water quantity 1.1-1.4 Weight Residue on ignition 4b Water quantity 1.1-1.4 Weight Residue on Ethanol 1 quantity 1.8-2.0 Weight ignition and Ethanol 1 addition time NLT 5 Minutes ethanol Ethanol 1 addition 40-60 ° C. temperature Hold time NLT 5 Minutes NLT = Not less than; NMT = Not more than Commercial Control Strategy

To confirm that the manufacture activities delivered a suitable product, an appropriate control strategy was implemented that included the following: Procedural controls—Controls provided by the nature of the GMP; Attribute controls—These controls were provided through the specification of each reagent, starting material, intermediate, and the drug substance; Parametric controls—These include the CPPs and their associated ranges. The control strategy for each CQA in migalastat hydrochloride drug substance is summarized in Table 48.

TABLE 48 Summary of control strategy Control CQA Stage or Material Element Details of Control Range or Limit Description Migalastat hydrochloride Specification Description White to pale brown crystal Identity Specification Identity Concordant with reference material Migalastat Specification Migalastat hydrochloride 98.0-102.0% w/w hydrochloride content content

IG migalastat hydrochloride Migalastat hydrochloride Specification Specification Compound W NGT 0.15% w/w NGT 0.15% w/w

Stage 3a       Stage 3c   IG migalastat hydrochloride Migalastat hydrochloride CPP       CPP   Specification Specification Palladium catalyst quantity Time Temperture Hydrogen pressure Temperature Time for ethanol addition Compound U Compound U 0.007-0.013 equiv. 44-68 hrs 40-50° C. 8-10 bar NLT 30° C. NLT 30 min NGT 0.4% w/w NGT 0.15% w/w

5-azido-5-deoxy-1,2,3,6- tetrapivaloyl-D-galactofuranoside Stage 3a     Stage 3c   IG migalastat hydrochloride Migalastat hydrochloride Specification   CPP     CPP   Specification Specification DMSO content   Palladium catalyst quantity Temperature Hydrogen pressure Temperature Time for ethanol addition Compound Y Compound Y <0.01% w/w   0.007-0.013 equiv. 40-50° C. 8-10 bar NLT 30° C. NLT 30 min 0.25% w/w 0.15% w/w

Stage 3c   IG migalastat hydrochloride Migalastat hydrochloride CPP   Specification Specification Temperature Time for ethanol addition Compound BB Compound BB NLT 30° C. NLT 30 min 0.3% w/w 0.15% w/w Methanol and ethanol Stage 4b CPP Water quantity 1.1-1.4 wts content Ethanol 1 quantity 1.8-2.0 wts Ethanol 1 addition time NLT 5 min Ethanol 1 addition temp 40-60° C. Hold time NLT 5 min Migalastat hydrochloride Specification Methanol and ethanol 0.3% w/w and 0.5% content w/w Water content Migalastat hydrochloride Specification Water content 0.2% w/w Heavy metals content Migalastat hydrochloride Specification Heavy metals content 20 mcg/g Residue on ignition Stage 3b CPP Filtration temperature 25-40° C. IG migalastat hydrochloride Specification Residue on ignition 7% w/w Stage 4a CPP Water quantity 1.1-1.4 wts Stage 4b CPP Water quantity 1.1-1.4 wts Migalastat hydrochloride Specification Residue on ignition 0.2% w/w Palladium content Migalastat hydrochloride Specification Palladium content NGT 10 ppm NGT = Not greater than; NLT = Not less than

Example 13: Small-Scale Verification Experiments

Verification experiments were conducted for some stages of the manufacturing process to verify that the overall control strategy would deliver intermediates and drug substance meeting specification, and that the ranges defined for CPPs in Stages 3 and 4 are appropriate in the extreme case where impurities are introduced at their specification limits.

The control strategy for the drug-related impurity CQAs was verified for Stages 3 and 4. In addition, studies were conducted to verify the control of residue on ignition in Stages 3 and 4 and the control of ethanol content in Stage 4.

Process impurities impacting CQAs were spiked, where appropriate, at their specification limits in the input materials. At the same time, the CPPs were set at forcing extremes of the ranges most likely to create failure in meeting output specifications (for this reason, not all of the CPPs were run at the limits of their ranges).

Stage 3 Verification Experiments

The objective of the verification experiments for Stage 3 was to demonstrate that the ranges defined for CPPs in Stage 3 will deliver migalastat hydrochloride which meets specification. This is achieved by selecting settings for the PARs which will increase levels of those CQAs impacted by Stage 3. Stage 3 impacts the drug-related impurity CQAs Compound U, Compound V, Compound W, Compound BB, and Compound Y. Stage 3 also impacts the genotoxin Compound X and the residue on ignition of migalastat hydrochloride.

The following verification experiments were undertaken: Experiment A—to confirm that migalastat hydrochloride produced did not fail drug substance specification under conditions selected to increase levels of Compound U, Compound Y, and Compound X; Experiments B and D—to confirm that migalastat hydrochloride produced did not fail drug substance specification under conditions selected to increase levels of Compound V; Experiment C—to confirm that migalastat hydrochloride produced did not fail drug substance specification under conditions selected to increase levels of Compound Y and residue on ignition.

Compound AA, Compound AA, and Compound W are potentially formed in Stage 3, but there are no CPPs for their control. The conditions employed in the Stage 3 experiments are provided in Table 49, alongside the ranges for each CPP and the current process setpoints. DMSO, which impacts the levels of Compound Y, was spiked at its specification limit of 0.01% w/w in experiments A and C. In addition, 35% w/w hydrochloric acid was used in all of the experiments to maximize the impact on residue on ignition. The intermediate grade migalastat hydrochloride produced in these experiments was recrystallized in Stage 4. Analytical data for the intermediate grade migalastat hydrochloride produced in these experiments are provided in Table 50. Data for the subsequent drug substance are provided in Table 51.

For experiments A and C, the intermediate grade migalastat hydrochloride produced after Stage 3 met specification. Furthermore, the drug substance produced after the intermediate grade migalastat hydrochloride was recrystallized in Stage 4 met the specification.

In experiment D, where the CPPs were fixed at setpoints, a higher level of Compound V was observed. In Experiment D, each of the CPPs was at the limit of the specified range. The migalastat hydrochloride produced after recrystallization in Stage 4 met the specification limit for Compound V.

Overall, the experiments verify that the control strategy established for Stage 3 will deliver migalastat hydrochloride within specification. In addition, the results verify that the CPPs have been correctly identified, as levels of the CQAs were increased under the experimental conditions.

TABLE 49 Summary of conditions for Stage 3 verification experiments Normal Target/ Stage CPP Unit Setpoint Range Experiment A Experiment B Experiment C Experiment D 3a Palladium catalyst Equiv 0.01 0.007- 0.007 0.013 0.007 0.013 quantity 0.013 Time for Stage 3a Hours NLT 44 44-68 44 68 68 44 Temperature in ° C. 45 40-50 40 45 40 45 Stage 3a Pressure in Stage 3a Barg 9  8-10 7 8 8 8 Methanol volumes Volumes 8 7-9 8 9 9 9 3b Residual weight Weights 0.7 NLT 0.5 0.5 0.7 0.7 0.7 after distillation Age time Hours NLT 1 NMT 10 10 5.5 5.5 5.5 Age temperature ° C. 50 40-55 50-55 45-50 45-50 45-50 Filtration ° C. 35 25-40 30-35 30-35 35-40 30-35 temperature 3c Temperature ° C. 25 NLT 15 15 15 15 15 Time for ethanol Minutes NLT 5 NLT 30 30 30 30 30 addition Migalastat hydrochloride CQAs and other attributes Compound U, Compound V Compound Y Compound V stressed to potentially challenge process Compound Y, and residue on and Compound ignition X NLT = Not less than; NMT = Not more than

TABLE 50 Results of Stage 3 verification experiments Specification Limit Attribute of Intermediate in IG Migalastat Grade Migalastat Hydrochloride Experiment A Experiment B Experiment C Experiment D Hydrochloride¹ CQA (% w/w) (% w/w) (% w/w) (% w/w) (% w/w) Compound W Y 0.15 ND 0.13 ND ND Compound U Y 0.4 0.35 <0.05 0.37 0.05 Compound AA N 0.15 0.06 0.05 0.06 0.05 Compound Z N 0.25 0.20 0.14 0.18 0.20 Any unspecified impurity² N 0.10 0.06 <0.05 <0.05 <0.05 Total impurities N 1.5 0.67 0.32 0.61 0.31 Compound V Y 0.40 0.05 0.25 0.06 0.29 Compound Y Y 0.25 0.08 0.05 0.14 0.07 Compound BB Y 0.3 0.28 0.23 0.24 0.27 Compound X² N Na (mcg/g) 31 mcg/g³ 10.6 mcg/g 2.6 mcg/g 18 mcg/g Residue on ignition Y 7 1.0 0.95 1.9 1.1 NA = Not applicable; ND = Not detected; ¹CQAs are highlighted in bold text; ²Not included on the specification for intermediate grade migalastat hydrochloride; ³This level is approximate, as the method for quantification of Compound X is validated for levels up to 18 mcg/g.

TABLE 50 Results of Stage 3 verification experiments Specification Limit Attribute of Intermediate in IG Migalastat Grade Migalastat Hydrochloride Experiment A Experiment B Experiment C Experiment D Hydrochloride¹ CQA (% w/w) (% w/w) (% w/w) (% w/w) (% w/w) Compound W Y 0.15 ND 0.06 ND ND Compound U Y 0.15 <0.05 ND <0.05 ND Compound AA N 0.10² ND ND ND ND Compound Z N 0.10² ND ND ND ND Any unspecified impurity³ N 0.10 ND ND ND ND Total impurities⁴ N 0.5 <0.05 0.06 <0.05 ND Compound V Y 0.15 <0.05 0.08 <0.05 0.09 Compound Y Y 0.15 <0.05 ND <0.05 <0.05 Compound BB Y 0.15 <0.05 ND <0.05 <0.05 Compound X N 12 (mcg/g) 6.1 mcg/g 1.4 mcg/g NGT 1.0 mcg/g 3.2 mcg/g Residue on ignition Y 0.2 (% w/w) <0.1 <0.1 <0.1 <0.1 ND = Not detected; NGT = Not greater than; ¹Drug-related impurity CQAs are highlighted in bold text; ²Controlled under unspecified impurities limit; ³Levels of the epimers Compound A, Compound EE, Compound DD, and Compound CC were all <0.1% w/w in these batches; ⁴The total impurities limit is determined by the drug-related impurities content by HPLC method only and exclude the Compound V, Compound Y, and Compound BB content determined by HPLC. Stage 4 Verification Experiments

Stage 4 controls the residue on ignition and ethanol content of migalastat hydrochloride, and impacts the drug-related impurity CQAs Compound U, Compound V, Compound Y, and Compound BB. The objective of the verification experiments was to confirm that, at the extremes of the Control Strategy for each CQA impacted by Stage 4, the migalastat hydrochloride produced did not fail the drug substance specification. The experiments were designed to combine CQAs at their specification limit in intermediate grade migalastat hydrochloride with the combination of setpoints for CPPs most likely to cause failure to meet drug substance specification. The following verification experiments were undertaken:

Experiment A—to confirm that migalastat hydrochloride, produced when incorporating levels of Compound W and Compound U at or above their specification limit in intermediate grade migalastat hydrochloride, did not fail drug substance specification. Processing under atypical conditions was used to generate the required levels of Compound U in the intermediate grade migalastat hydrochloride. To confirm the impact of incorporating Compound V, Compound Y, and Compound BB at their specification limit in intermediate grade migalastat hydrochloride with a standard impurity profile, experiment D was also carried out. Experiment B—to confirm that migalastat hydrochloride, produced when incorporating levels of residue on ignition at the specification limit in intermediate grade migalastat hydrochloride, did not fail drug substance specification under conditions designed to maximize levels of residue on ignition and ethanol content. Experiment C—to confirm that migalastat hydrochloride produced did not fail drug substance specification under conditions designed to maximize levels of ethanol content. Stage 4a was not carried out on Experiment C. Experiment D—to confirm that migalastat hydrochloride, produced when incorporating levels of Compound V, Compound Y, and Compound BB at significantly higher levels than typical in intermediate grade migalastat hydrochloride, did not fail drug substance acceptance criteria.

Table 52 shows a summary of the conditions employed in Stage 4 verification experiments. Table 53 shows the analytical data from the migalastat hydrochloride isolated from these experiments.

TABLE 52 Summary of conditions for Stage 4 verification experiments Setpoint/ Stage CPP Unit Target Range Experiment A Experiment B Experiment C Experiment D 4a Water quantity Weights 1.3 1.1-1.4 1.1 1.1 NA 1.1 4b Water quantity Weights 1.3 1.1-1.4 1.1 1.1 1.4 1.1 Ethanol 1 quantity Weights 1.9 1.8-2.0 2.0 2.0 1.8 2.0 Ethanol 1 addition Minutes NLT 5 NLT 5 5 5 5 5 time Ethanol 1 addition ° C. 50 40-60 40 40 60 40 temperature Hold time Minutes NLT 5 NLT 5 5 5 5 5 Migalastat hydrochloride CQAs stressed to Compound W Residue on Ethanol Compound V, potentially fail drug substance specification Compound U ignition and content Compound Y, ethanol and Compound content BB NA = Not applicable; NLT = Not less than

TABLE 53 Spiking Levels and Results of Stage 4 Verification Experiments Specification Specification Limit in IG Limit in Attribute of Migalastat Migalastat Migalastat HCl HCl Experiment A Experiment B Experiment C Experiment D Hydrochloride¹ CQA (% w/w) (% w/w) Input Output Input Output Input Output Input Output Compound W Y 0.15 0.15 0.12 0.13 <0.05 <0.05 <0.05 <0.05 ND ND Compound U Y 0.4 0.15 0.59 0.06 ND ND ND ND ND ND Compound AA² N 0.15 0.10 0.41 ND ND ND ND ND <0.05 ND Compound Z² N 0.25 0.10 0.70 ND ND ND ND ND 0.27 ND Any other impurity N 0.10 0.10 0.15 <0.05 ND ND ND ND 0.06 ND Total impurities³ N 1.5 0.50 1.97 0.19 <0.05 <0.05 <0.05 <0.05 0.32 ND Compound V Y 0.40 0.15 0.13 0.11 0.06 <0.05 0.06 0.07 0.41 0.12 Compound Y Y 0.25 0.15 1.42 0.54⁴ <0.05 ND <0.05 ND 0.32 <0.05 Compound BB Y 0.3 0.15 0.22 <0.05 <0.05 ND <0.05 ND 0.22 ND Residue on ignition Y 7 0.20 1.4 <0.10 7.0 <0.10 — <0.10 0.28⁵ <0.10 Ethanol Y NA 0.50 NA 0.07 NA 0.07 NA 0.23 NA 0.10 NA = Not applicable; ND = Not detected; ¹Drug-related impurity CQAs are highlighted in bold text; ²Controlled in itermediate grade migalastat hydrochloride and migalastat hydrochloride under any unspecified impurity; ³The total impurities limit is determined by the drug-related impurities content by HPLC method only and exclude the Compound V, Compound Y, and Compound BB content determined by HPLC; ⁴Due to the conditions used to generate the required levels of Compound U in this experiment, the input level of Compound Y was significantly higher than the intermediate grade migalastat hydrochloride specification limit; ⁵Residue on ignition calculated from constituent input materials.

As shown by the output data in Table 53, except for the level of Compound Y in Experiment A, the migalastat hydrochloride produced met the specification. Due to the conditions used to generate the required level of Compound U in Experiment A, the input level of Compound Y was significantly higher than its specification limit in intermediate grade migalastat hydrochloride. Experiment D was, therefore, also carried out to ensure that the specification limits for Compound Y, Compound V, and Compound BB in intermediate grade migalastat hydrochloride specification were appropriate. The experiments verified that the specification limits for intermediate grade migalastat hydrochloride and the CPP ranges defined for Stage 4 deliver migalastat hydrochloride that meets the drug substance specification.

TABLE 54 Reference Table for Chemical Structures Reference No. Chemical Structure D-(+)-galactose

5-azido-5-deoxy- 1,2,3,6-tetrapivaloyl- D-galactofuranoside

L-altrose

Glycerol

Lactic acid

Compound C

Compound E

Compound G

1,2,3,6- tetrapivaloyl-D- galactofuranoside

migalastat hydrochloride

Glucose

Compound A

Compound B

Compound D

Compound F

Compound H

Compound I

Compound K

Compound M

Compound O

Compound Q

Compound S

Compound U

Compound J

Compound L

Compound N

Compound P

Compound R

Compound T

Migalastat

Compound V

Compound X

Compound Z

Compound BB

Compound DD

Compound W

Compound Y

Compound AA

Compound CC

Compound EE

TABLE 55 HEK Amenable Mutations Protein Change Protein Change DNA Change (Long) DNA Change (Short) (1-letter Code) (3-letter Code) c.7C>G c.C7G p.(L3V) p.(Leu3Val) c.8T>C c.T8C p.(L3P) p.(Leu3Pro) c.[11G>T; 620A>C] c.G11T/A620C p.(R4M/Y207S) p.(Arg4Met/Tyr207Ser) c.37G>A c.G37A p.(A13T) p.(Ala13Thr) c.37G>C c.G37C p.(A13P) p.(Ala13Pro) c.43G>A c.G43A p.(A15T) p.(Ala15Thr) c.44C>G c.C44G p.(A15G) p.(Ala15Gly) c.53T>G c.T53G p.(F18C) p.(Phe18Cys) c.58G>C c.G58C p.(A20P) p.(Ala20Pro) c.59C>A c.C59A p.(A20D) p.(Ala20Asp) c.65T>G c.T65G p.(V22G) p.(Val22Gly) c.70T>C or c.70T>A c.T70C or c.T70A p.(W24R) p.(Trp24Arg) c.70T>G c.T70G p.(W24G) p.(Trp24Gly) c.72G>C or c.72G>T c.G72C or c.G72T p.(W24C) p.(Trp24Cys) p.(A29D) p.(Ala29Asp) c.95T>C c.T95C p.(L32P) p.(Leu32Pro) c.97G>T c.G97T p.(D33Y) p.(Asp33Tyr) c.98A>G c.A98G p.(D33G) p.(Asp33Gly) c.100A>C c.A100C p.(N34H) p.(Asn34His) c.100A>G c.A100G p.(N34D) p.(Asn34Asp) c.101A>C c.A101C p.(N34T) p.(Asn34Thr) c.101A>G c.A101G p.(N34S) p.(Asn34Ser) c.102T>G or c.T102G or c.T102A p.(N34K) p.(Asn34Lys) c.102T>A c.103G>C or c.G103C or c.G103A p.(G35R) p.(Gly35Arg) c.103G>A c.104G>A c.G104A p.(G35E) p.(Gly35Glu) c.104G>T c.G104T p.(G35V) p.(Gly35Val) c.107T>C c.T107C p.(L36S) p.(Leu36Ser) c.107T>G c.T107G p.(L36W) p.(Leu36Trp) c.108G>C or c.G108C or c.G108T p.(L36F) p.(Leu36Phe) c.108G>T c.109G>A c.G109A p.(A37T) p.(Ala37Thr) c.110C>T c.C110T p.(A37V) p.(Ala37Val) p.(R112L) p.(Arg112Leu) c.122C>T c.C122T p.(T41I) p.(Thr41Ile) c.124A>C or c.A124C or c.A124T p.(M42L) p.(Met42Leu) c.124A>T c.124A>G c.A124G p.(M42V) p.(Met42Val) c.125T>A c.T125A p.(M42K) p.(Met42Lys) c.125T>C c.T125C p.(M42T) p.(Met42Thr) c.125T>G c.T125G p.(M42R) p.(Met42Arg) c.126G>A or c.G126A or c.G126C p.(M42I) p.(Met42Ile) c.126G>C or or c.G126T c.126G>T c.137A>C c.A137C p.(H46P) p.(His46Pro) c.142G>C c.G142C p.(E48Q) p.(Glu48Gln) c.152T>A c.T152A p.(M51K) p.(Met51Lys) c.153G>A or c.G153A or c.G153T p.(M51I) p.(Met51Ile) c.153G>T or or c.G153C c.153G>C c.[157A>C; 158A>T] c.A157C/A158T p.(N53L) p.(Asn53Leu) c.157A>G c.A157G p.(N53D) p.(Asn53Asp) c.160C>T c.C160T p.(L54F) p.(Leu54Phe) c.161T>C c.T161C p.(L54P) p.(Leu54Pro) c.164A>G c.A164G p.(D55G) p.(Asp55Gly) c.164A>T c.A164T p.(D55V) p.(Asp55Val) c.[164A>T; 170A>T] c.A164T/A170T p.(D55V/Q57L) p.(Asp55Val/Gln57Leu) c.167G>A c.G167A p.(C56Y) p.(Cys56Tyr) c.167G>T c.G167T p.(C56F) p.(Cys56Phe) c.170A>T c.A170T p.(Q57L) p.(Gln57Leu) c.175G>A c.G175A p.(E59K) p.(Glu59Lys) c.178C>A c.C178A p.(P60T) p.(Pro60Thr) c.178C>T c.C178T p.(P60S) p.(Pro60Ser) c.179C>T c.C179T p.(P60L) p.(Pro60Leu) c.196G>A c.G196A p.(E66K) p.(Glu66Lys) c.197A>G c.A197G p.(E66G) p.(Glu66Gly) c.207C>A or c.C207A or c.C207G p.(F69L) p.(Phe69Leu) c.207C>G c.214A>G c.A214G p.(M72V) p.(Met72Val) c.216G>A or c.G216A or c.G216T p.(M72I) p.(Met72Ile) c.216G>T or or c.G216C c.216G>C c.218C>T c.C218T p.(A73V) p.(Ala73Val) c.227T>C c.T227C p.(M76T) p.(Met76Thr) c.239G>A c.G239A p.(G80D) p.(Gly80Asp) c.239G>T c.G239T p.(G80V) p.(Gly80Val) c.247G>A c.G247A p.(D83N) p.(Asp83Asn) c.253G>A c.G253A p.(G85S) p.(Gly85Ser) c.[253G>A; 254G>A] c.G253A/G254A p.(G85N) p.(Gly85Asn) c.[253G>A; 254G>T; c.G253A/G254T/T255G p.(G85M) p.(Gly85Met) 255T>G] c.254G>A c.G254A p.(G85D) p.(Gly85Asp) c.261G>C or c.G261C or c.G261T p.(E87D) p.(Glu87Asp) c.261G>T c.265C>T c.C265T p.(L89F) p.(Leu89Phe) c.272T>C c.T272C p.(I91T) p.(Ile91Thr) c.288G>A or c.G288A or c.G288T p.(M96I) p.(Met96Ile) c.288G>T or or c.G288C c.288G>C c.289G>C c.G289C p.(A97P) p.(Ala97Pro) c.290C>T c.C290T p.(A97V) p.(Ala97Val) c.305C>T c.C305T p.(S102L) p.(Ser102Leu) c.311G>T c.G311T p.(G104V) p.(Gly104Val) c.316C>T c.C316T p.(L106F) p.(Leu106Phe) c.320A>G c.A320G p.(Q107R) p.(Gln107Arg) c.322G>A c.G322A p.(A108T) p.(Ala108Thr) c.326A>G c.A326G p.(D109G) p.(Asp109Gly) c.334C>G c.C334G p.(R112G) p.(Arg112Gly) c.335G>A c.G335A p.(R112H) p.(Arg112His) c.337T>A c.T337A p.(F113I) p.(Phe113Ile) c.337T>C or c.339T>A c.T337C or c.T339A or p.(F113L) p.(Phe113Leu) or c.339T>G c.T339G c.352C>T c.C352T p.(R118C) p.(Arg118Cys) c.361G>A c.G361A p.(A121T) p.(Ala121Thr) c.368A>G c.A368G p.(Y123C) p.(Tyr123Cys) c.373C>T c.C373T p.(H125Y) p.(His125Tyr) c.374A>T c.A374T p.(H125L) p.(His125Leu) c.376A>G c.A376G p.(S126G) p.(Ser126Gly) c.383G>A c.G383A p.(G128E) p.(Gly128Glu) c.399T>G c.T399G p.(I133M) p.(Ile133Met) c.404C>T c.C404T p.(A135V) p.(Ala135Val) c.408T>A or c.T408A or c.T408G p.(D136E) p.(Asp136Glu) c.408T>G c.416A>G c.A416G p.(N139S) p.(Asn139Ser) c.419A>C c.A419C p.(K140T) p.(Lys140Thr) c.427G>A c.G427A p.(A143T) p.(Ala143Thr) c.431G>A c.G431A p.(G144D) p.(Gly144Asp) c.431G>T c.G431T p.(G144V) p.(Gly144Val) c.434T>C c.T434C p.(F145S) p.(Phe145Ser) c.436C>T c.C436T p.(P146S) p.(Pro146Ser) c.437C>G c.C437G p.(P146R) p.(Pro146Arg) c.454T>C c.T454C p.(Y152H) p.(Tyr152His) c.454T>G c.T454G p.(Y152D) p.(Tyr152Asp) c.455A>G c.A455G p.(Y152C) p.(Tyr152Cys) c.466G>A c.G466A p.(A156T) p.(Ala156Thr) c.466G>T c.G466T p.(A156S) p.(Ala156Ser) c.467C>T c.C467T p.(A156V) p.(Ala156Val) c.471G>C or c.G471C or c.G471T p.(Q157H) p.(Gln157His) c.471G>T p.(F159C) p.(Phe159Cys) c.484T>G c.T484G p.(W162G) p.(Trp162Gly) c.493G>C c.G493C p.(D165H) p.(Asp165His) c.494A>G c.A494G p.(D165G) p.(Asp165Gly) c.496_497delinsTC c.496_497delinsTC p.(L166S) p.(Leu166Ser) c.496C>G c.C496G p.(L166V) p.(Leu166Val) c.[496C>G; 497T>G] c.C496G/T497G p.(L166G) p.(Leu166Gly) c.499C>G c.C499G p.(L167V) p.(Leu167Val) c.506T>C c.T506C p.(F169S) p.(Phe169Ser) c.511G>A c.G511A p.(G171S) p.(Gly171Ser) c.520T>C c.T520C p.(C174R) p.(Cys174Arg) c.520T>G c.T520G p.(C174G) p.(Cys174Gly) c.525C>G or c.C525G or c.C525A p.(D175E) p.(Asp175Glu) c.525C>A c.539T>G c.T539G p.(L180W) p.(Leu180Trp) c.540G>C or c.G540C or c.G540T p.(L180F) p.(Leu180Phe) c.540G>T c.548G>A c.G548A p.(G183D) p.(Gly183Asp) c.548G>C c.G548C p.(G183A) p.(Gly183Ala) c.550T>A c.T550A p.(Y184N) p.(Tyr184Asn) c.551A>G c.A551G p.(Y184C) p.(Tyr184Cys) p.(Y184S) p.(Tyr184Ser) c.553A>G c.A553G p.(K185E) p.(Lys185Glu) c.559_564dup c.559_564dup p.(M187_S188dup) p.(Met187_Ser188dup) c.559A>G c.A559G p.(M187V) p.(Met187Val) c.560T>C c.T560C p.(M187T) p.(Met187Thr) c.561G>T or c.G561T or c.G561A p.(M187I) p.(Met187Ile) c.561G>A or or c.G561C c.561G>C c.567G>C or c.G567C or c.G567T p.(L189F) p.(Leu189Phe) c.567G>T c.572T>A c.T572A p.(L191Q) p.(Leu191Gln) c.581C>T c.C581T p.(T194I) p.(Thr194Ile) c.584G>T c.G584T p.(G195V) p.(Gly195Val) c.586A>G c.A586G p.(R196G) p.(Arg196Gly) c.593T>C c.T593C p.(I198T) p.(Ile198Thr) c.595G>A c.G595A p.(V199M) p.(Val199Met) c.596T>C c.T596C p.(V199A) p.(Val199Ala) c.596T>G c.T596G p.(V199G) p.(Val199Gly) c.599A>G c.A599G p.(Y200C) p.(Tyr200Cys) c.602C>A c.C602A p.(S201Y) p.(Ser201Tyr) c.602C>T c.C602T p.(S201F) p.(Ser201Phe) c.608A>T c.A608T p.(E203V) p.(Glu203Val) c.609G>C or c.G609C or c.G609T p.(E203D) p.(Glu203Asp) c.609G>T c.611G>T c.G611T p.(W204L) p.(Trp204Leu) c.613C>A c.C613A p.(P205T) p.(Pro205Thr) c.613C>T c.C613T p.(P205S) p.(Pro205Ser) c.614C>T c.C614T p.(P205L) p.(Pro205Leu) c.619T>C c.T619C p.(Y207H) p.(Tyr207His) c.620A>C c.A620C p.(Y207S) p.(Tyr207Ser) c.623T>G c.T623G p.(M208R) p.(Met208Arg) c.628C>T c.C628T p.(P210S) p.(Pro210Ser) c.629C>T c.C629T p.(P210L) p.(Pro210Leu) c.638A>G c.A638G p.(K213R) p.(Lys213Arg) c.638A>T c.A638T p.(K213M) p.(Lys213Met) c.640C>T c.C640T p.(P214S) p.(Pro214Ser) c.641C>T c.C641T p.(P214L) p.(Pro214Leu) c.643A>G c.A643G p.(N215D) p.(Asn215Asp) c.644A>G c.A644G p.(N215S) p.(Asn215Ser) c.[644A>G; 937G>T*] c.A644G/G937T* p.(N215S/D313Y*) p.(Asn215Ser/Asp313Tyr*) c.644A>T c.A644T p.(N215I) p.(Asn215Ile) c.646T>G c.T646G p.(Y216D) p.(Tyr216Asp) c.647A>G c.A647G p.(Y216C) p.(Tyr216Cys) c.655A>C c.A655C p.(I219L) p.(Ile219Leu) c.656T>A c.T656A p.(I219N) p.(Ile219Asn) c.656T>C c.T656C p.(I219T) p.(Ile219Thr) c.659G>A c.G659A p.(R220Q) p.(Arg220Gln) c.659G>C c.G659C p.(R220P) p.(Arg220Pro) c.662A>C c.A662C p.(Q221P) p.(Gln221Pro) c.671A>C c.A671C p.(N224T) p.(Asn224Thr) c.671A>G c.A671G p.(N224S) p.(Asn224Ser) c.673C>G c.C673G p.(H225D) p.(His225Asp) c.683A>G c.A683G p.(N228S) p.(Asn228Ser) p.(N228H) p.(Asn228His) c.687T>A or c.T687A or c.T687G p.(F229L) p.(Phe229Leu) c.687T>G c.695T>C c.T695C p.(I232T) p.(Ile232Thr) c.712A>G c.A712G p.(S238G) p.(Ser238Gly) c.713G>A c.G713A p.(S238N) p.(Ser238Asn) c.716T> C c.T716C p.(I239T) p.(Ile239Thr) c.717A>G c.A717G p.(I239M) p.(Ile239Met) c.720G>C or c.G720C or c.G720T p.(K240N) p.(Lys240Asn) c.720G>T c.724A>G c.A724G p.(I242V) p.(Ile242Val) c.724A>T c.A724T p.(I242F) p.(Ile242Phe) c.725T>A c.T725A p.(I242N) p.(Ile242Asn) c.725T>C c.T725C p.(I242T) p.(Ile242Thr) c.728T>G c.T728G p.(L243W) p.(Leu243Trp) c.729G>C or c.G729C or c.G729T p.(L243F) p.(Leu243Phe) c.729G>T c.730G>A c.G730A p.(D244N) p.(Asp244Asn) c.730G>C c.G730C p.(D244H) p.(Asp244His) c.733T>G c.T733G p.(W245G) p.(Trp245Gly) c.740C>G c.C740G p.(S247C) p.(Ser247Cys) c.747C>G or c.C747G or c.C747A p.(N249K) p.(Asn249Lys) c.747C>A c.749A>C c.A749C p.(Q250P) p.(Gln250Pro) c.749A>G c.A749G p.(Q250R) p.(Gln250Arg) c.750G>C c.G750C p.(Q250H) p.(Gln250His) c.758T>C c.T758C p.(I253T) p.(Ile253Thr) c.758T>G c.T758G p.(I253S) p.(Ile253Ser) c.760-762delGTT or c.760_762delGTT or p.(V254del) p.(Val254del) c.761763del c.761_763del c.769G>C c.G769C p.(A257P) p.(Ala257Pro) c.770C>G c.C770G p.(A257G) p.(Ala257Gly) c.770C>T c.C770T p.(A257V) p.(Ala257Val) c.772G>C or c.G772C or c.G772A p.(G258R) p.(Gly258Arg) c.772G>A c.773G>T c.G773T p.(G258V) p.(Gly258Val) c.776C>A c.C776A p.(P259Q) p.(Pro259Gln) c.776C>G c.C776G p.(P259R) p.(Pro259Arg) c.776C>T c.C776T p.(P259L) p.(Pro259Leu) c.779G>A c.G779A p.(G260E) p.(Gly260Glu) c.779G>C c.G779C p.(G260A) p.(Gly260Ala) c.781G>A c.G781A p.(G261S) p.(Gly261Ser) c.781G>C c.G781C p.(G261R) p.(Gly261Arg) c.781G>T c.G781T p.(G261C) p.(Gly261Cys) c.788A>G c.A788G p.(N263S) p.(Asn263Ser) c.790G>T c.G790T p.(D264Y) p.(Asp264Tyr) c.794C>T c.C794T p.(P265L) p.(Pro265Leu) c.800T>C c.T800C p.(M267T) p.(Met267Thr) c.805G>A c.G805A p.(V269M) p.(Val269Met) c.806T>C c.T806C p.(V269A) p.(Val269Ala) c.809T>C c.T809C p.(I270T) p.(Ile270Thr) c.810T>G c.T810G p.(I270M) p.(Ile270Met) c.811G>A c.G811A p.(G271S) p.(Gly271Ser) c.[811G>A; 937G>T*] c.G811A/G937T* p.(G271S/D313Y*) p.(Gly271Ser/Asp313Tyr*) c.812G>A c.G812A p.(G271D) p.(Gly271Asp) c.823C>G c.C823G p.(L275V) p.(Leu275Val) c.827G>A c.G827A p.(S276N) p.(Ser276Asn) c.829T>G c.T829G p.(W277G) p.(Trp277Gly) c.831G>T or c.G831T or c.G831C p.(W277C) p.(Trp277Cys) c.831G>C c.832A>T c.A832T p.(N278Y) p.(Asn278Tyr) c.835C>G c.C835G p.(Q279E) p.(Gln279Glu) c.838C>A c.C838A p.(Q280K) p.(Gln280Lys) c.840A>T or c.A840T or c.A840C p.(Q280H) p.(Gln280His) c.840A>C c.844A>G c.A844G p.(T282A) p.(Thr282Ala) c.845C>T c.C845T p.(T282I) p.(Thr282Ile) c.850A>G c.A850G p.(M284V) p.(Met284Val) c.851T>C c.T851C p.(M284T) p.(Met284Thr) c.860G>T c.G860T p.(W287L) p.(Trp287Leu) c.862G>C c.G862C p.(A288P) p.(Ala288Pro) c.866T>G c.T866G p.(I289S) p.(Ile289Ser) c.868A>C or c.A868C or c.A868T p.(M290L) p.(Met290Leu) c.868A>T c.869T>C c.T869C p.(M290T) p.(Met290Thr) c.870G>A or c.G870A or c.G870C p.(M290I) p.(Met290Ile) c.870G>C or or c.G870T c.870G>T c.871G>A c.G871A p.(A291T) p.(Ala291Thr) c.877C>A c.C877A p.(P293T) p.(Pro293Thr) c.881T>C c.T881C p.(L294S) p.(Leu294Ser) c.884T>G c.T884G p.(F295C) p.(Phe295Cys) c.886A>G c.A886G p.(M296V) p.(Met296Val) c.886A>T or c.A886T or c.A886C p.(M296L) p.(Met296Leu) c.886A>C c.887T>C c.T887C p.(M296T) p.(Met296Thr) c.888G>A or c.G888A or c.G888T p.(M296I) p.(Met296Ile) c.888G>T or or c.G888C c.888G>C c.893A>G c.A893G p.(N298S) p.(Asn298Ser) c.897C>G or c.C897G or c.C897A p.(D299E) p.(Asp299Glu) c.897C>A c.898C>T c.C898T p.(L300F) p.(Leu300Phe) c.899T>C c.T899C p.(L300P) p.(Leu300Pro) c.901C>G c.C901G p.(R301G) p.(Arg301Gly) c.902G>A c.G902A p.(R301Q) p.(Arg301Gln) c.902G>C c.G902C p.(R301P) p.(Arg301Pro) c.902G>T c.G902T p.(R301L) p.(Arg301Leu) c.907A>T c.A907T p.(I303F) p.(Ile303Phe) c.908T>A c.T908A p.(I303N) p.(Ile303Asn) p.(I303V) p.(Ile303Val) c.911G>A c.G911A p.(S304N) p.(Ser304Asn) c.911G>C c.G911C p.(S304T) p.(Ser304Thr) c.919G>A c.G919A p.(A307T) p.(Ala307Thr) c.922A>G c.A922G p.(K308E) p.(Lys308Glu) c.924A>T or c.A924T or c.A924C p.(K308N) p.(Lys308Asn) c.924A>C c.925G>C c.G925C p.(A309P) p.(Ala309Pro) c.926C>T c.C926T p.(A309V) p.(Ala309Val) c.928C>T c.C928T p.(L310F) p.(Leu310Phe) c.931C>G c.C931G p.(L311V) p.(Leu311Val) c.935A>G c.A935G p.(Q312R) p.(Gln312Arg) c.936G>T or c.G936T or c.G936C p.(Q312H) p.(Gln312His) c.936G>C c.937G>T* c.G937T* p.(D313Y*) p.(Asp313Tyr*) c.[937G>T*; c.G937T*/G1232A p.(D313Y*/ p.(Asp313Tyr*/ 1232G>A] G411D) Gly411Asp) c.938A>G c.A938G p.(D313G) p.(Asp313Gly) c.946G>A c.G946A p.(V316I) p.(Val316Ile) c.947T>G c.T947G p.(V316G) p.(Val316Gly) c.950T>C c.T950C p.(I317T) p.(Ile317Thr) c.955A>T c.A955T p.(I319F) p.(Ile319Phe) c.956T>C c.T956C p.(I319T) p.(Ile319Thr) c.958A>C c.A958C p.(N320H) p.(Asn320His) c.959A>T c.A959T p.(N320I) p.(Asn320Ile) c.962A>G c.A962G p.(Q321R) p.(Gln321Arg) c.962A>T c.A962T p.(Q321L) p.(Gln321Leu) c.963G>C or c.G963C or c.G963T p.(Q321H) p.(Gln321His) c.963G>T c.964G>A c.G964A p.(D322N) p.(Asp322Asn) c.964G>C c.G964C p.(D322H) p.(Asp322His) c.966C>A or c.C966A or c.C966G p.(D322E) p.(Asp322Glu) c.966C>G c.967C>A c.C967A p.(P323T) p.(Pro323Thr) c.968C>G c.C968G p.(P323R) p.(Pro323Arg) c.973G>A c.G973A p.(G325S) p.(Gly325Ser) c.973G>C c.G973C p.(G325R) p.(Gly325Arg) p.(G325C) p.(Gly325Cys) c.978G>C or c.G978C or c.G978T p.(K326N) p.(Lys326Asn) c.978G>T c.979C>G c.C979G p.(Q327E) p.(Gln327Glu) c.980A>T c.A980T p.(Q327L) p.(Gln327Leu) c.983G>C c.G983C p.(G328A) p.(Gly328Ala) c.989A>G c.A989G p.(Q330R) p.(Gln330Arg) p.(Q330P) p.(Gln330Pro) c.1001G>A c.G1001A p.(G334E) p.(Gly334Glu) c.1010T>C c.T1010C p.(F337S) p.(Phe337Ser) c.1012G>A c.G1012A p.(E338K) p.(Glu338Lys) c.1013A>T c.A1013T p.(E338V) p.(Glu338Val) c.1016T>A c.T1016A p.(V339E) p.(Val339Glu) c.1027C>A c.C1027A p.(P343T) p.(Pro343Thr) c.1028C>T c.C1028T p.(P343L) p.(Pro343Leu) c.1033T>C c.T1033C p.(S345P) p.(Ser345Pro) c.1046G>C c.G1046C p.(W349S) p.(Trp349Ser) c.1055C>G c.C1055G p.(A352G) p.(Ala352Gly) c.1055C>T c.C1055T p.(A352V) p.(Ala352Val) c.1061T>A c.T1061A p.(I354K) p.(Ile354Lys) c.1066C>G c.C1066G p.(R356G) p.(Arg356Gly) c.1066C>T c.C1066T p.(R356W) p.(Arg356Trp) c.1067G>A c.G1067A p.(R356Q) p.(Arg356Gln) c.1067G>C c.G1067C p.(R356P) p.(Arg356Pro) c.1072G>C c.G1072C p.(E358Q) p.(Glu358Gln) c.1073A>C c.A1073C p.(E358A) p.(Glu358Ala) c.1073A>G c.A1073G p.(E358G) p.(Glu358Gly) c.1074G>T or c.G1074T or c.G1074C p.(E358D) p.(Glu358Asp) c.1074G>C c.1076T>C c.T1076C p.(I359T) p.(Ile359Thr) c.1078G>A c.G1078A p.(G360S) p.(Gly360Ser) c.1078G>T c.G1078T p.(G360C) p.(Gly360Cys) p.(G360R) p.(Gly360Arg) c.1079G>A c.G1079A p.(G360D) p.(Gly360Asp) c.1082G>A c.G1082A p.(G361E) p.(Gly361Glu) c.1082G>C c.G1082C p.(G361A) p.(Gly361Ala) c.1084C>A c.C1084A p.(P362T) p.(Pro362Thr) c.1085C>T c.C1085T p.(P362L) p.(Pro362Leu) c.1087C>T c.C1087T p.(R363C) p.(Arg363Cys) c.1088G>A c.G1088A p.(R363H) p.(Arg363His) c.1102G>A c.G1102A p.(A368T) p.(Ala368Thr) c.1117G>A c.G1117A p.(G373S) p.(Gly373Ser) c.1124G>A c.G1124A p.(G375E) p.(Gly375Glu) c.1139C>T c.C1139T p.(P380L) p.(Pro380Leu) c.1153A>G c.A1153G p.(T385A) p.(Tyr385Ala) p.(L388F) p.(Leu388Phe) c.1168G>A c.G1168A p.(V390M) p.(Val390Met) c.1172A>C c.A1172C p.(K391T) p.(Lys391Thr) p.(L394P) p.(Leu394Pro) c.1184G>A c.G1184A p.(G395E) p.(Gly395Glu) c.1184G>C c.G1184C p.(G395A) p.(Gly395Ala) c.1192G>A c.G1192A p.(E398K) p.(Glu398Lys) c.1202_1203insGACTTC c.1202_1203insGACTTC p.(T400_S401dup) p.(Thr400_Ser401dup) c.1208T>C c.T1208C p.(L403S) p.(Leu403Ser) c.1225C>A c.C1225A p.(P409T) p.(Pro409Thr) c.1225C>G c.C1225G p.(P409A) p.(Pro409Ala) c.1225C>T c.C1225T p.(P409S) p.(Pro409Ser) c.1228A>G c.A1228G p.(T410A) p.(Thr410Ala) c.1229C>T c.C1229T p.(T410I) p.(Thr410Ile) c.1232G>A c.G1232A p.(G411D) p.(Gly411Asp) c.1234A>C c.A1234C p.(T412P) p.(Thr412Pro) c.1235C>A c.C1235A p.(T412N) p.(Thr412Asn) p.(T412I) p.(Thr412Ile) c.1253A>G c.A1253G p.(E418G) p.(Glu418Gly) p.(N419D) p.(Asn419Asp) c.1261A>G c.A1261G p.(M421V) p.(Met421Val)

TABLE 56 HEK Amenable Mutations Nucleotide change Nucleotide change Protein sequence change c.7C>G c.C7G L3V c.8T>C c.T8C L3P c.[11G>T; 602A>C] c.G11T/A620C R4M/Y207S c.13A>G c.A13G N5D c.15C>G c.C15G N5K c.16C>A c.C16A P6T c.16C>T c.C16T P6S c.17C>A c.C17A P6Q c.17C>G c.C17G P6R c.17C>T c.C17T P6L c.19G>A c.G19A E7K c.20A>T c.A20T E7V c.21A>T c.A21T E7D c.22C>A c.C22A L8I c.23T>A c.T23A L8Q c.23T>C c.T23C L8P c.25C>T c.C25T H9Y c.26A>G c.A26G H9R c.26A>T c.A26T H9L c.27T>A c.T27A H9Q c.28C>A c.C28A L10M c.28C>G c.C28G L10V c.29T>A c.T29A L10Q c.29T>C c.T29C L10P c.29T>G c.T29G L10R c.31G>A c.G31A G11S c.31G>C c.G31C G11R c.31G>T c.G31T G11C c.32G>A c.G32A G11D c.32G>T c.G31T G11V c.34T>A c.T34A C12S c.34T>C c.T34C C12R c.34T>G c.T34G C12G c.35G>A c.G35A C12Y c.37G>A c.G37A A13T c.37G>C c.G37C A13P c.38C>A c.C38A A13E c.38C>G c.C38G A13G c.40C>G c.C40G L14V c.40C>T c.C40T L14F c.41T>A c.T41A L14H c.43G>A c.G43A A15T c.44C>G c.C44G A15G c.49C>A c.C49A R15S c.49C>G c.C49G R17G c.49C>T c.C49T R17C c.50G>A c.G50A R17H c.50G>C c.G50C R17P c.52T>A c.T52A F18I c.53T>G c.T53G F18C c.54C>G c.C54G F18L c.58G>C c.G58C A20P c.59C>A c.C59A A20D c.59C>G c.C59G A20G c.62T>A c.T62A L21H c.64G>A c.G64A V22I c.64G>C c.G64C V22L c.64G>T c.G64T V22F c.65T>C c.T65C V22A c.65T>G c.T65G V22G c.67T>A c.T67A S23T c.67T>C c.T67C S23P c.70T>C or c.70T>A c.T70C or c.T70A W27R c.70T>G c.T70G W24G c.71G>C c.G71C W24S c.72G>C or c.72G>T c.G72C or c.G72T W24C c.73G>C c.G73C D25H c.77T>A c.T77A I26N c.79C>A c.C79A P27T c.79C>G c.C79G P27A c.79C>T c.C79T P27S c.80C>T c.C80T P27L c.82G>C c.G82C G28R c.82G>T c.G82T G28W c.83G>A c.G83A c.G28E c.85G>C c.G85C A29P c.86C>A c.C86A A29D c.86C>G c.C86G A29G c.86C>T c.C86T A29V c.88A>G c.A88G R30G c.94C>A c.C94A L32M c.94C>G c.C94G L32V c.95T>A c.T95A L32Q c.95T>C c.T95C L32P c.95T>G c.T95G L32R c.97G>C c.G97C D33H c.97G>T c.G97T D33Y c.98A>C c.A98C D33A c.98A>G c.A98G D33G c.98A>T c.A98T D33V c.99C>G c.C99G D33E c.100A>C c.A100C N34H c.100A>G c.A100G N34D c.101A>C c.A101C N34T c.101A>G c.A101G N34S c.102T>G or c.102T>A c.T102G or c.T102A N34K c.103G>C or c.103G>A c.G103C or c.G103A G35R c.104G>A c.G104A G35E c.104G>C c.G104C G35A c.104G>T c.G104T G35V c.106T>A c.T106A L36M c.106T>G c.T106G L36V c.107T>C c.T107C L36S c.107T>G c.T107G L36W c.108G>C or c.108G>T c.G108C or c.G108T L36F c.109G>A c.G109A A37T c.109G>T c.G109T A37S c.110C>A c.C110A A37E c.110C>G c.C110G A37G c.110C>T c.C110T A37V c.112A>G c.A112G R38G c.112A>T c.A112T R38W c.113G>T c.G113T R38M c.114G>C c.G114C R38S c.115A>G c.A115G T39A c.115A>T c.A115T T39S c.116C>A c.C116A T39K c.116C>G c.C116G T39R c.116C>T c.C116T T39M c.121A>G c.A121G T41A c.122C>A c.C112A T41N c.122C>G c.C112G T41S c.122C>T c.C112T T41I c.124A>C or c.C124A>T c.A124C or c.A124T M42L c.124A>G c.A124G M42V c.125T>A c.T125A M42K c.125T>C c.T125C M42T c.125T>G c.T125G M42R c.126G>A or c.126G>C or c.G126A or c.G126C or c.G126T M42I c.126G>T c.128G>C c.G128C G43A c.133C>A c.C133A L45M c.135C>G c.C133G L45V c.136C>A c.C136A H46N c.136C>G c.C136G H46D c.137A>C c.A137C H46P c.138C>G c.C138G H46Q c.142G>C c.G142C E48Q c.143A>C c.A143C E48A c.149T>A c.T149A F50Y c.151A>G c.A151G M51V c.152T>A c.T152A M51K c.152T>C c.T152C M51T c.152T>G c.T152G M51R c.153G>A or c.153G>T or c.G153A or c.G153T or c.G153C M51I c.153G>C c.157A>C c.A157C N53H c.[157A>C; 158A>T] c.A157C/A158T N53L c.157A>G c.A157G N53D c.157A>T c.A157T N53Y c.158A>C c.A158C N53T c.158A>G c.A158G N53S c.158A>T c.A158T N53I c.159C>G or c.159C>A c.C159G or c.C159A N53K c.160C>G c.C160G L54V c.160C>T c.C160T L54F c.161T>A c.T161A L54H c.161T>C c.T161C L54P c.161T>G c.T161G L54R c.163G>C c.G163C D55H c.163G>T c.G163T D55Y c.164A>C c.A164C D55A c.164A>G c.A164G D55G c.164A>T c.A164T D55V c.[164A>T; 170A>T] c.A164T/A170T D55V/Q57L c.165C>G c.C165G D55E c.167G>A c.G167A C56Y c.167G>T c.G167T C56F c.168C>G c.C168G C56W c.170A>G c.A170G Q57R c.170A>T c.A170T Q57L c.172G>A c.G172A E58K c.175G>A c.G175A E59K c.175G>C c.G175C E59Q c.176A>C c.A176C E59A c.176A>G c.A176G E59G c.176A>T c.A176T E59V c.177G>C c.G177C E59D c.178C>A c.C178A P60T c.178C>G c.C178G P60A c.178C>T c.C178T P60S c.179C>A c.C179A P60Q c.179C>G c.C179G P60R c.179C>T c.C179T P60L c.182A>T c.A182T D61V c.183T>A c.T183A D61E c.184_185insTAG c.184_185insTAG S62delinsLA c.184T>C c.T184C S62P c.184T>G c.T184G S62A c.185C>A c.C185A S62Y c.185C>G c.C185G S62C c.185C>T c.C185T S62F c.190A>C c.A190C I64L c.190A>G c.A190G I64V c.193A>G c.A193G S65G c.193A>T c.A193T S65C c.195T>A c.T195A S65R c.196G>A c.G196A E66K c.197A>G c.A197G E66G c.197A>T c.A197T E66V c.198G>C c.G198C E66D c.199A>C c.A199C K67Q c.199A>G c.A199G K67E c.200A>C c.A200C K67T c.200A>T c.A200T K67M c.201G>C c.G201C K67N c.202C>A c.C202A L68I c.205T>A c.T205A F69I c.206T>A c.T206A T69Y c.207C>A or c.207C>G c.C207A or c.C207G F69L c.208A>T c.A208T M70L c.209T>A c.T209A M70K c.209T>G c.T209G M70R c.210G>C c.G210C M70I c.211G>C c.G211C E71Q c.212A>C c.A212C E71A c.212A>G c.A212G E71G c.212A>T c.A212T E71V c.213G>C c.G213C E71D c.214A>G c.A214G M72V c.214A>T c.A214T M72L c.215T>C c.T215C M72T c.216G>A or c.216G>T or c.G216A or G216T or M72I c.216C>G c.G216C c.217G>A c.G217A A73T c.217G>T c.G217T A73S c.218C>T c.C218T A73V c.220G>A c.G220A E74K c.221A>G c.A221G E74G c.221A>T c.A221T E74V c.222G>C c.G222C E74D c.223C>T c.C223T L75F c.224T>C c.T224C L75P c.226A>G c.A226G M76V c.227T>C c.T227C M76T c.229G>A c.G229A V77I c.229G>C c.G229C V77L c.232T>C c.T232C S78P c.233C>T c.C233T S78L c.235G>A c.G235A E79K c.235G>C c.G235C E79Q c.236A>C c.A236C E79A c.236A>G c.A236G E79G c.236A>T c.A236T E79V c.237A>T c.A237T E79D c.238G>A c.G238A G80S c.238G>T c.G238T G80C c.239G>A c.G239A G80D c.239G>C c.G239C G80A c.239G>T c.G239T G80V c.242G>T c.G242T W81L c.244A>G c.A244G K82E c.245A>C c.A245C K82T c.245A>G c.A245G K82R c.245A>T c.A245T K82M c.246G>C c.G246C K82N c.247G>A c.G247A D83N c.248A>C c.A248C D83A c.248A>G cA248G D83G c.248A>T c.A248T D83V c.249T>A c.T249A D83E c.250G>A c.G250A A84T c.250G>C c.G250C A84P c.250G>T c.G250T A84S c.251C>A c.C251A A84E c.251C>G c.C251G A84G c.251C>T c.C251T A84V c.253G>A c.G253A G85S c.[253G>A; 254G>A] c.G253A/G254A G85N c.[253G>A; 254G>T; 255T>G] c.G253A/G254T/T255G G85M c.253G>C c.G253C G85R c.253G>T c.G253T G85C c.254G>A c.G254A G85D c.254G>C c.G254C G85A c.257A>T c.A257T Y86F c.260A>G c.A260G E87G c.261G>C or c.261G>T c.G261C or c.G261T E87D c.262T>A c.T262A Y88N c.262T>C c.T262C Y88H c.263A>C c.A263C Y88S c.263A>G c.A263G Y88C c.265C>G c.C265G L89V c.265C>T c.C265T L89F c.271A>C c.A271C I91L c.271A>T c.A271T I91F c.272T>C c.T272C I91T c.272T>G c.T272G I91S c.273T>G c.T273G I91M c.286A>G c.A286G M96V c.286A>T c.A286T M96L c.287T>C c.T287C M96T c.288G>A or c.288G>T or c.G288A or c.G288T or M96I c.288G>C G288C c.289G>A c.G289A A97T c.289G>C c.G289C A97P c.289G>T c.G289T A97S c.290C>A c.C290A A97D c.290C>T c.C290T A97V c.293C>A c.C293A P98H c.293C>G c.C293G P98R c.293C>T c.C293T P98L c.295C>G c.C295G Q99E c.296A>C c.A296C Q99P c.296A>G c.A296G Q99R c.296A>T c.A296T Q99L c.301G>C c.G301C D101H c.302A>C c.A302C D101A c.302A>G c.A302G D101G c.302A>T c.A302T D101V c.303T>A c.T303A D101E c.304T>A c.T304A S102T c.304T>C c.T304C S102P c.304T>G c.T304G S102A c.305C>T c.C305T S102L c.310G>A c.G310A G104S c.311G>A c.G311A G104D c.311G>C c.G311C G104A c.311G>T c.G311T G104V c.313A>G c.A313G R105G c.314G>A c.G314A R105K c.314G>C c.G314C R105T c.314G>T c.G314T R105I c.316C>A c.C316A L106I c.316C>G c.C316G L106V c.316C>T c.C316T L106F c.317T>A c.T317A L106H c.317T>C c.T317C L106P c.319C>A c.C319A Q107K c.319C>G c.C319G Q107E c.320A>G c.A320G A107R c.321G>C c.G321C Q107H c.322G>A c.G322A A108T c.323C>A c.C323A A108E c.323C>T c.C323T A108V c.325G>A c.G325A D109N c.325G>C c.G325C D109H c.325G>T c.G325T D109Y c.326A>C c.A326C D109A c.326A>G c.A326G D109G c.327C>G c.C327G D109E c.328C>A c.C328A P110T c.334C>G c.C334G R112G c.335G>A c.G335A R112H c.335G>T c.G335T R112L c.337T>A c.T337A F113I c.337T>C or c.339T>A or c.T337C or c.T339A or c.T339G F113L c.339T>G c.337T>G c.T337G F113V c.338T>A c.T338A F113Y c.341C>T c.C341T P114L c.343C>A c.C343A H115N c.343C>G c.C343G H115D c.346G>C c.G346C G116R c.350T>C c.T350C I117T c.351T>G c.T351G I117M c.352C>T c.C352T R118C c.361G>A c.G361A A121T c.362C>T c.C362T A121V c.367T>A c.T367A Y123N c.367T>G c.T367G Y123D c.368A>C c.A368C Y123S c.368A>G c.A368G Y123C c.368A>T c.A368T Y123F c.370G>A c.G370A V124I c.371T>G c.T371G V124G c.373C>A c.C373A H125N c.373C>G c.C373G H125D c.373C>T c.C373T H125Y c.374A>G c.A374G H125R c.374A>T c.A374T H125L c.376A>G c.A376G S126G c.376A>T c.A376T S126C c.377G>T c.G377T S126I c.379A>G c.A379G K127E c.383G>A c.G383A G128E c.383G>C c.G383C G128A c.385C>G c.C385G L129V c.388A>C c.A388C K130Q c.389A>T c.A389T K130M c.390G>C c.G390C K130N c.391C>G c.C391G L131V c.397A>C c.A397C I133L c.397A>G c.A397G I133V c.397A>T c.A397T I133F c.398T>C c.T398C I133T c.399T>G c.T399G I133M c.[399T>G; 434T>C] c.T399G/T343C T133M/F145S c.403G>A c.G403A A135T c.403G>T c.G403T A135S c.404C>A c.G404A A135E c.404C>G c.C404G A135G c.404C>T c.C404T A135V c.406G>A c.G406A D136N c.407A>C c.A407C D136A c.407A>T c.A407T D136V c.408T>A or c.408T>G c.T408A or c.T408G D136E c.409G>A c.G409A V137I c.409G>C c.G409C V137L c.410T>A c.T410A V137D c.410T>C c.T410C V137A c.410T>G c.T410G V137G c.413G>C c.G413C G138A c.415A>C c.A415C N139H c.415A>T c.A415T N139Y c.416A>G c.A416G N139S c.416A>T c.A416T N139I c.417T>A c.T417A N139K c.418A>C c.A418C K140Q c.418A>G c.A418G K140E c.419A>C c.A419C K140T c.419A>G c.A419G K140R c.419A>T c.A419T K140I c.420A>T c.A420T K140N c.421A>T c.A421T T141S c.427G>A c.G427A A143T c.428C>A c.C428A A143E c.428C>G c.C428G A143G c.428C>T c.C428T A143V c.430G>A c.G430A G144S c.430G>C c.G430C G144R c.430G>T c.G430T G144C c.431G>A c.G431A G144D c.431G>C c.G431C G144A c.431G>T c.G431T G144V c.433T>G c.T433G F145V c.434T>A c.T434A F145Y c.434T>C c.T434C F145S c.434T>G c.T434G F145C c.435C>G c.C435G F145L c.436C>A c.C436A P146T c.436C>G c.C436G P149A c.436C>T c.C436T P146S c.437C>A c.C437A P146H c.437C>G c.C437G P146R c.437C>T c.C437T R146L c.440G>C c.G440C G147A c.442A>G c.A442G S148G c.442A>T c.A442T S148C c.443G>C c.G443C S148T c.446T>G c.T446G F149C c.449G>A c.G449A G150E c.449G>T c.G449T G150V c.451T>G c.T451G Y151D c.452A>C c.A452C Y151S c.452A>G c.A452G Y151C c.454T>A c.T454A Y152N c.454T>C c.T454C Y152H c.454T>G c.T454G Y152D c.455A>C c.A455C Y152S c.455A>G c.A455C Y152C c.455A>T c.A455T Y152F c.457G>A c.G457A D153N c.457G>C c.G457C D153H c.457G>T c.G457T D153Y c.458A>C c.A458C D153A c.458A>T c.A458T D153V c.465T>A or c.465T>G c.T465A or c.T465G D155E c.466G>A c.G466A A156T c.466G>T c.G466T A156S c.467C>G c.C467G A156G c.467C>T c.C467T A156V c.469C>A c.C469A Q157K c.469C>G c.C469G Q157E c.470A>C c.A470C Q157P c.470A>T c.A470T Q157L c.471G>C or c.471G>T c.G471C or c.G471T Q157H c.472A>G c.A472G T158A c.472A>T c.A472T T158S c.473C>A c.C473A T158N c.473C>T c.C473T T158I c.475T>A c.T475A F159I c.475T>G c.T475G F159V c.476T>A c.T476A F159Y c.476T>G c.T476G F159C c.477T>A c.T447A F159L c.478G>A c.G478A A160T c.478G>T c.G478T A160S c.479C>A c.C479A A160D c.479C>G c.C479G A160G c.479C>T c.C479T A160V c.481G>A c.G481A D161N c.481G>C c.G481C D161H c.481G>T c.G481T D161Y c.482A>T c.A482T D161V c.484T>G c.T484G W162G c.485G>C c.G485C W162S c.490G>A c.G490A V164I c.490G>T c.G490T V164L c.491T>C c.T491C V164A c.493G>A c.G493A D165N c.493G>C c.G493C D165H c.494A>C c.A494C D165A c.494A>G c.A494G D165G c.495T>A c.T495A D165E c.496_497delinsTC c.496_497delinsTC L166S c.496C>A c.C496A L166M c.496C>G c.C496G L166V c.[496C>G; 497T>G] c.C496G/T497G L166G c.497T>A c.T497A L166Q c.499C>A c.C499A L167I c.499C>G c.C499G L167V c.505T>A c.T505A F169I c.505T>G c.T505G F169V c.506T>A c.T506A F169Y c.506T>C c.T506C F169S c.506T>G c.T506G F169C c.507T>A c.T507A F169L c.511G>A c.G511A G171S c.512G>C c.G512C G171A c.512G>T c.G512T G171V c.517T>C c.T517C Y173H c.518A>C c.A581C Y173S c.518A>G c.A518G Y173C c.518A>T c.A518T Y173F c.520T>C c.T520C C174R c.520T>G c.T520G C174G c.523G>C c.G523C D175H c.523G>T c.G523T D175Y c.524A>G c.A524G D175G c.524A>T c.A524T D175V c.525C>G or c.525C>A c.C525G or c.525A D175E c.526A>T c.A526T S176C c.528T>A c.T528A S176R c.529T>A c.T529A L177M c.529T>G c.T529G L177V c.530T>C c.T530C L177S c.530T>G c.T530G L177W c.531G>C c.G531C L177F c.532G>A c.G532A E178K c.532G>C c.G532C E178Q c.533A>C c.A533C E178A c.533A>G c.A533G E178G c.538T>A c.T538A L180M c.538T>G c.T538G L180V c.539T>C c.T539C L180S c.539T>G c.T539G L180W c.540G>C or c.540G>T c.G540C or c.G540T L180F c.541G>A c.G541A A181T c.541G>C c.G541C A181P c.542C>T c.C542T A181V c.544G>T c.G544T D182Y c.545A>C c.A545C D182A c.545A>G c.A545G D182G c.545A>T c.A545T D182V c.546T>A c.T546A D182E c.548G>A c.G548A G183D c.548G>C c.G548C G183A c.550T>A c.T550A Y184N c.550T>C c.T550C Y184H c.551A>C c.A551C Y184S c.551A>G c.A551G Y184C c.551A>T c.A551T Y184F c.553A>C c.A553C K185Q c.553A>G c.A553G K185E c.554A>C c.A554C K185T c.554A>T c.A554T K185M c.555G>C c.G555C K185N c.556C>A c.C556A H186N c.556C>G c.C556G H186D c.556C>T c.C556T H186Y c.557A>T c.A557T H186L c.558C>G c.C558G H186Q c.559_564dup c.559_564dup p.M187_S188dup c.559A>T c.A559T M187L c.559A>G c.A559G M187V c.560T>C c.T560C M187T c.561G>T or c.561G>A or c.G561T or c.G561A or c.G561C M187I c.561G>C c.562T>A c.T562A S188T c.562T>C c.T562C S188P c.562T>G c.T562G S188A c.563C>A c.C563A S188Y c.563C>G c.C563G S188C c.563C>T c.C563T S188F c.565T>G c.T565G L189V c.566T>C c.T556C L189S c.567G>C or c.567G>T c.G567C or c.G567T L189F c.568G>A c.G568A A190T c.568G>T c.G568T A190S c.569C>A c.C569A A190D c.569C>G c.C569G A190G c.569C>T c.C569T A190V c.571C>A c.C571A L191M c.571C>G c.C571G L191V c.572T>A c.T572A L191Q c.574A>C c.A574C N192H c.574A>G c.A574G N192D c.575A>C c.A575C N192T c.575A>G c.A575G N192S c.576T>A c.T576A N192K c.577A>G c.A577G R193G c.577A>T c.A577T R193W c.578G>C c.G578C R193T c.578G>T c.G578T R193M c.580A>C c.A580C T194P c.580A>G c.A580G T194A c.580A>T or c.581C>G c.A580T or c.C581G T194S c.581C>A c.C581A T194N c.581C>T c.C581T T194I c.583G>A c.G583A G195S c.583G>C c.G583C G195R c.583G>T c.G583T G195C c.584G>T c.G584T G195V c.586A>G c.A586G R196G c.587G>A c.G587A R196K c.587G>C c.G587C R196T c.587G>T c.G587T R196I c.589A>G c.A589G S197G c.589A>T c.A589T S197C c.590G>A c.G590A S197N c.590G>C c.G590C S197T c.590G>T c.G590T S197I c.593T>C c.T593C I198T c.593T>G c.T593G I198S c.594T>G c.T594G I198M c.595G>A c.G595A V199M c.595G>C c.G595C V199L c.596T>A c.T596A V199E c.596T>C c.T596C V199A c.596T>G c.T596G V199G c.598T>A c.T598A Y200N c.599A>C c.A599C Y200S c.599A>G c.A599G Y200C c.601T>A c.T601A S201T c.601T>G c.T601G S201A c.602C>A c.C602A S201Y c.602C>G c.C602G S201C c.602C>T c.C602T S201F c.607G>C c.G607C E203Q c.608A>C c.A608C E203A c.608A>G c.A608G E203G c.608A>T c.A608T E203V c.609G>C or c.609G>T c.G609C or c.G609T E203D c.610T>G c.T610G W204G c.611G>C c.G611C W204S c.611G>T c.G611T W204L c.613C>A c.C613A P205T c.613C>T c.C613T P205S c.614C>T c.C614T P205L c.616C>A c.C616A L206I c.616C>G c.C616G L206V c.616C>T c.C616T L206F c.617T>A c.T617A L206H c.617T>G c.T617G L206R c.619T>C c.T619C Y207H c.620A>C c.A620C Y207S c.620A>T c.A620T Y207F c.623T>A c.T623A M208K c.623T>G c.T623G M208R c.625T>A c.T625A W209R c.625T>G c.T625G W209G c.627G>C c.G627C W209C c.628C>A c.C628A P210T c.628C>T c.C628T P210S c.629C>A c.C629A P210H c.629C>T c.C629T P210L c.631T>C c.T631C F211L c.631T>G c.T631G F211V c.632T>A c.T632A F211Y c.632T>C c.T632C F211S c.632T>G c.T632G F211C c.635A>C c.A635C Q212P c.636A>T c.A636T Q212H c.637A>C c.A637C K213Q c.637A>G c.A637G K213E c.638A>G c.A638G K213R c.638A>T c.A638T K213M c.640C>A c.C640A P214T c.640C>G c.C640G P214A c.640C>T c.C640T P214S c.641C>A c.C641A P214H c.641C>G c.C641G P214R c.641C>T c.C641T P214L c.643A>C c.A643C N215H c.643A>G c.A643G N215D c.643A>T c.A643T N215Y c.644A>C c.A644C N215T c.644A>G c.A644G N215S c.[644A>G; 937G>T] c.A644G/G937T D215S/D313Y c.644A>T c.A644T N215I c.645T>A c.T645A N215K c.646T>A c.T646A Y216N c.646T>C c.T646C Y216H c.646T>G c.T646G Y216D c.647A>C c.A647C Y216S c.647A>G c.A647G Y216C c.647A>T c.A647T Y216F c.649A>C c.A649C T217P c.649A>G c.A649G T217A c.649A>T c.A649T T217S c.650C>A c.C650A T217K c.650C>G c.C650G T217R c.650C>T c.C650T T217I c.652G>A c.G652A E218K c.652G>C c.G652C E218Q c.653A>C c.A653C E218A c.653A>G c.A653G E218G c.653A>T c.A653T E218V c.654A>T c.A654T E218D c.655A>C c.A655C I219L c.655A>T c.A655T I219F c.656T>A c.T646A I219N c.656T>C c.T656C I219T c.656T>G c.T656G I219S c.657C>G c.C657G I219M c.659G>A c.G659A R220Q c.659G>C c.G659C R220P c.659G>T c.G659T R220L c.661C>A c.C661A Q221K c.661C>G c.C661G Q221E c.662A>C c.A662C Q221P c.662A>G c.A662G Q221R c.662A>T c.A662T Q221L c.663G>C c.G663C Q221H c.664T>A c.T664A Y22N c.664T>C c.T664C Y22H c.664T>G c.T664G Y22D c.665A>C c.A665C Y222S c.665A>G c.A665G Y22C c.670A>C c.A670C N224H c.671A>C c.A671C N224T c.671A>G c.A671G N224S c.673C>G c.C673G H225D c.679C>G c.C679G R227G c.682A>C c.A682C N228H c.682A>G c.A682G N228D c.683A>C c.A683C N228T c.683A>G c.A683G N228S c.683A>T c.A683T N228I c.685T>A c.T685A F229I c.686T>A c.T686A F229Y c.686T>C c.T686C F229S c.687T>A or c.687T>G c.T687A or c.T687G F229L c.688G>C c.G686C A230P c.689C>A c.C689A A230D c.689C>G c.C689G A230G c.689C>T c.C689T A230V c.694A>C c.A694C I232L c.694A>G c.A694G I232V c.695T>C c.T695C I232T c.696T>G c.T695G I232M c.698A>C c.A698C D233A c.698A>G c.A698G D233G c.698A>T c.A698T D233V c.699T>A c.T699A D233E c.703T>A c.T703A S235T c.703T>G c.T703G S235A c.710A>T c.A710T K237I c.712A>G c.A712G S238G c.712A>T c.A712T S238C c.713G>A c.G713A S238N c.713G>C c.G713C S238T c.713G>T c.G713T S238I c.715A>T c.A715T I239L c.716T>C c.T716C I239T c.717A>G c.A717G I239M c.718A>G c.A718G K240E c.719A>G c.A719G K240R c.719A>T c.A719T K240M c.720G>C or c.720G>T c.G720C or c.G720T K240N c.721A>T c.A721T S241C c.722G>C c.G722C S241T c.722G>T c.G722T S241I c.724A>C c.A724C I241L c.724A>G c.A724G I242V c.724A>T c.A724T I242F c.725T>A c.T725A I242N c.725T>C c.T725C I242T c.725T>G c.T725G I242S c.726C>G c.C726G I242M c.727T>A c.T727A L243M c.727T>G c.T727G L243V c.728T>C c.T728C L243S c.728T>G c.T728G L243W c.729G>C or c.729G>T c.G729C or c.G729T L243F c.730G>A c.G730A D244N c.730G>C c.G730C D244H c.730G>T c.G730T D244Y c.731A>C c.A731C D244A c.731A>G c.A731G D244G c.731A>T c.A731T D244V c.732C>G c.C732G D244E c.733T>G c.T733G W245G c.735G>C c.G735C W245C c.736A>G c.A736G T246A c.737C>A c.C737A T246K c.737C>G c.C737G T246R c.737C>T c.C737T T246I c.739T>A c.T739A S247T c.739T>G c.T739G S247A c.740C>A c.C740A S247Y c.740C>G c.C740G S247C c.740C>T c.C740T S247F c.742T>G c.T742G F248V c.743T>A c.T743A F248Y c.743T>G c.T743G F248C c.744T>A c.T744A F248L c.745A>C c.A745C N249H c.745A>G c.A745G N249D c.745A>T c.A745T N249Y c.746A>C c.A746C N249T c.746A>G c.A746G N249S c.746A>T c.A746T N249I c.747C>G or c.747C>A c.C747G or c.C747A N249K c.748C>A c.C748A Q250K c.748C>G c.C748G Q250E c.749A>C c.A749C Q250P c.749A>G c.A749G Q250R c.749A>T c.A749T Q250L c.750G>C c.G750C Q250H c.751G>A c.G751A E251K c.751G>C c.G751C E251Q c.752A>G c.A752G E251G c.752A>T c.A752T E251V c.754A>G c.A754G R252G c.757A>G c.A757G I253V c.757A>T c.A757T I253F c.758T>A c.T758A I253N c.758T>C c.T758C I253T c.758T>G c.T758G I253S c.760_762delGTT or c.760_762delGTT or c.761_763del p.V254del c.T761-763del c.760G>T c.G760T V254F c.761T>A c.T761A V254D c.761T>C c.T761C V254A c.761T>G c.T761G V254G c.763G>A c.G763A D255N c.763G>C c.G763C D255H c.763G>T c.G763T D255Y c.764A>C c.A764C D255A c.764A>T c.A764T D255V c.765T>A c.T765A D255E c.766G>C c.G766C V256L c.767T>A c.T767A V256D c.767T>G c.T767G V256G c.769G>A c.G769A A257T c.769G>C c.G769C A257P c.769G>T c.G769T A257S c.770C>G c.C770G A257G c.770C>T c.C770T A257V c.772G>C or c.772G>A c.G772C or c.G772A G258R c.773G>A c.G773A G258E c.773G>T c.G773T G258V c.775C>A c.C775A P259T c.775C>G c.C775G P259A c.775C>T c.C775T P259S c.776C>A c.C776A P259Q c.776C>G c.C776G P259R c.776C>T c.C776T P259L c.778G>T c.C778T G260W c.779G>A c.G779A G260E c.779G>C c.C779C G260A c.781G>A c.G781A G261S c.781G>C c.C781C G261R c.781G>T c.G781T G261C c.782G>C c.G782C G261A c.787A>C c.A787C N263H c.788A>C c.A788C N263T c.788A>G c.A788G N263S c.790G>A c.G790A D264N c.790G>C c.G790C D264H c.790G>T c.G790T D264Y c.793C>G c.C793G P265A c.794C>A c.C794A P265Q c.794C>T c.C794T P265L c.799A>G c.A799G M267V c.799A>T c.A799T M267L c.800T>C c.T800C M267T c.802T>A c.T802A L268I c.804A>T c.A804T L268F c.805G>A c.G805A V269M c.805G>C c.G805C V269L c.806T>C c.T806C V269A c.808A>C c.A808C I270L c.808A>G c.A808G I270V c.809T>C c.T809C I270T c.809T>G c.T809G I270S c.810T>G c.T810G I270M c.811G>A c.G811A G271S c.[811G>A; 937G>T] c.G811A/G937T G271S/D313Y c.812G>A c.G812A G271D c.812G>C c.G812C G271A c.814A>G c.A814G N272D c.818T>A c.T818A F273Y c.823C>A c.C823A L275I c.823C>G c.C823G L275V c.827G>A c.G827A S276N c.827G>C c.G827C S276T c.829T>G c.T829G W277G c.830G>T c.G830T W277L c.831G>T or c.831G>C c.G831T or c.G831C W277C c.832A>T c.A832T N278Y c.833A>T c.A833T N278I c.835C>G c.C835G Q279E c.838C>A c.C838A Q280K c.839A>G c.A839G Q280R c.839A>T c.A839T Q280L c.840A>T or c.840A>C c.A840T or c.A840C Q280H c.841G>C c.G841C V281L c.842T>A c.T842A V281E c.842T>C c.T842C V281A c.842T>G c.T842G V281G c.844A>G c.A844G T282A c.844A>T c.A844T T282S c.845C>T c.C845T T282I c.847C>G c.C874G Q283E c.848A>T c.A848T Q283L c.846G>C c.G849C Q283H c.850A>G c.A850G M284V c.850A>T c.A850T M284L c.851T>C c.T851C M284T c.852G>C c.G852C M284I c.853G>A c.G853A A285T c.854C>G c.C854G A285G c.854C>T c.C854T A285V c.856C>G c.C856G L286V c.856C>T c.C856T L286F c.857T>A c.T857A L286H c.860G>T c.G860T W287L c.862G>C c.G862C A288P c.862G>T c.G862T A288S c.863C>G c.C863G A288G c.863C>T c.C863T A288V c.865A>C c.A865C I289L c.865A>G c.A865G I289V c.866T>C c.T866C I289T c.866T>G c.T866G I289S c.868A>C or c.868A>T c.A868C or c.A868T M290L c.868A>G c.A868G M290V c.869T>C c.T869C M290T c.870G>A or c.870G>C or c.C870A or c.G870C or M290I c.870G>T c.G870T c.871G>A c.G871A A291T c.871G>T c.G871T A291S c.872C>G c.C872G A291G c.874G>T c.G874T A292S c.875C>G c.C875G A292G c.877C>A c.C877A P293T c.880T>A c.T880A L294I c.880T>G c.T880G L294V c.881T>C c.T881C L294S c.882A>T c.A882T L294F c.883T>A c.T883A F295I c.883T>G c.T883G F295V c.884T>A c.T884A F295Y c.884T>C c.T884C F295S c.884T>G c.T884G F295C c.886A>G c.A886G M296V c.886A>T or c.886A>C c.A886T or c.A886C M296L c.887T>C c.T887C M296T c.888G>A or c.886G>T or c.G888A or c.G888T or c.C888C M296I c.888G>C c.889T>A c.T889A S297T c.892A>G c.A892G N298D c.893A>C c.A893C N298T c.893A>G c.A893G N298S c.893A>T c.A893T N298I c.895G>A c.G895A D299N c.895G>C c.G895C D299H c.897C>G or c.897C>A c.C897G or c.C897A D299E c.898C>A c.C898A L300I c.898C>G c.C898G L300V c.898C>T c.C898T L300F c.899T>C c.T899C L300P c.901C>G c.C901G R301G c.902G>A c.G902A R301Q c.902G>C c.G902C R301P c.902G>T c.G902T R301L c.904C>A c.C904A H302N c.904C>G c.C904G H302D c.904C>T c.C904T H302Y c.905A>T c.A905T H302L c.907A>G c.A907G I303V c.907A>T c.A907T I303F c.908T>A c.T908A I303N c.908T>C c.T908C I303T c.908T>G c.T908G I303S c.911G>A c.G911A S304N c.911G>C c.G911C S304T c.911G>T c.G911T S304I c.916C>G c.C916G Q306E c.917A>C c.A917C Q306P c.917A>T c.A917T Q306L c.919G>A c.G919A A307T c.919G>C c.G919C A307P c.919G>T c.G919T A307S c.920C>A c.C920A A307D c.920C>G c.C920G A307G c.920C>T c.C920T A307V c.922A>C c.A922C K308Q c.922A>G c.A922G K308E c.923A>G c.A923G K308R c.923A>T c.A923T K308I c.924A>T or c.924A>C c.A924T or c.A924C K308N c.925G>A c.G925A A309T c.925G>C c.G925C A309P c.926C>A c.C926A A309D c.926C>T c.C926T A309V c.928C>A c.C928A L310I c.928C>G c.C928G L310V c.928C>T c.C928T L310F c.931C>A c.C931A L311I c.931C>G c.C931G L311V c.934C>A c.C934A Q312K c.934C>G c.C934G Q312E c.935A>G c.A935G Q312R c.935A>T c.A935T Q312L c.936G>T or c.936G>C c.G936T or c.G936C Q312H c.937G>T c.G937T D313Y c.[937G>T; 1232G>A] c.G937T/G1232A D313Y/G411D c.938A>G c.A938G D313G c.938A>T c.A938T D313V c.939T>A c.T939A D313E c.940A>G c.A940G K314E c.941A>C c.A941C K314T c.941A>T c.A941T K314M c.942G>C c.G942C K314N c.943G>A c.G943A D315N c.943G>C c.G943C D315H c.943G>T c.G943T D315Y c.944A>C c.A944C D315A c.944A>G c.A944G D315G c.944A>T c.A944T D315V c.946G>A c.G976A V316I c.946G>C c.G946C V316L c.947T>C c.T974C V316A c.947T>G c.T947G V316G c.949A>C c.A949C I317L c.949A>G c.A949G I317V c.950T>C c.T950C I317T c.951T>G c.T951G I317M c.952G>A c.G952A A318T c.952G>C c.G952C A318P c.953C>A c.C953A A318D c.953C>T c.C953T A318V c.955A>T c.A955T I319F c.956T>C c.T956C I319T c.957C>G c.C957G I319M c.958A>C c.A958C N320H c.959A>C c.A959C N320T c.959A>G c.A959G N320S c.959A>T c.A959T N320I c.961C>A c.C961A Q321K c.962A>G c.A962G Q321R c.962A>T c.A962T Q321L c.963G>C or c.963G>T c.G963C or c.G963T Q321H c.964G>A c.G964A D322N c.964G>C c.G964C D322H c.965A>C c.A965C D322A c.965A>T c.A965T D322V c.966C>A or c.966C>G c.C966A or c.C966G D322E c.967C>A c.C967A P323T c.968C>G c.C968G P323R c.970T>G c.T970G L324V c.971T>G c.T971G L324W c.973G>A c.G973A G325S c.973G>C c.G973C G325R c.973G>T c.G973T G325C c.974G>C c.G974C G325A c.974G>T c.G974T G325V c.976A>C c.A976C K326Q c.976A>G c.A976G K326E c.977A>C c.A977C K326T c.977A>G c.A977G K326R c.977A>T c.A977T K326M c.978G>C or c.978G>T c.G978C or c.G978T K326N c.979C>G c.C979G Q327E c.980A>C c.A980C Q327P c.980A>T c.A980T Q327L c.981A>T c.A981T Q327H c.983G>C c.G983C G328A c.985T>A c.T985A Y329N c.985T>C c.T985C Y329H c.985T>G c.T985G Y329D c.986A>G c.A986G Y329C c.986A>T c.A986T Y329E c.988C>A c.C988A Q330K c.988C>G c.C988G Q330E c.989A>C c.A989C Q330P c.989A>G c.A989G Q330R c.990G>C c.G990C Q330H c.991C>G c.C991G L331V c.992T>A c.T992A L331H c.992T>C c.T992C L331P c.992T>G c.T992G L331R c.994A>G c.A994G R332G c.995G>C c.G995C R332T c.995G>T c.G995T R332I c.996A>T c.A996T R332S c.997C>G c.C997G Q333E c.998A>C c.A998C Q333P c.998A>T c.A998T Q333L c.1000G>C c.G1000C G334R c.1001G>A c.G1001A G334E c.1001G>T c.G1001T G334V c.1003G>T c.G1003T D335Y c.1004A>C c.A1004C D335A c.1004A>G c.A1004G D335G c.1004A>T c.A1004T D335V c.1005C>G c.C1005G D335E c.1006A>G c.A1006G N336D c.1006A>T c.A1006T N336Y c.1007A>C c.A1007C N336T c.1007A>G c.A1007G N336S c.1007A>T c.A1007T N336I c.1009T>G c.T1009G F337V c.1010T>A c.T1010A F337Y c.1010T>C c.T1010C F337S c.1010T>G c.T1010G F337C c.1011T>A c.T1011A F337L c.1012G>A c.G1012A E338K c.1013A>C c.A1013C E338A c.1013A>G c.A1013G E338G c.1013A>T c.A1013T E338V c.1014A>T c.A1014T E338D c.1015G>A c.G1015A V339M c.1016T>A c.T1016A V339E c.1016T>C c.T1016C V339A c.1021G>C c.G1021C E341Q c.1022A>C c.A1022C E341A c.1027C>A c.C1027A P343T c.1027C>G c.C1027G P343A c.1027C>T c.C1027T P343S c.1028C>T c.C1028T P343L c.1030C>G c.C1030G L344V c.1030C>T c.C1030T L344F c.1031T>G c.T1031G L344R c.1033T>C c.T1033C S345P c.1036G>T c.G1036T G346C c.1037G>A c.G1037A G346D c.1037G>C c.G1037C G346A c.1037G>T c.G1037T G346V c.1039T>A c.T1039A L347I c.1043C>A c.C1043A A348D c.1046G>C c.G1046C W349S c.1046G>T c.G1046T W349L c.1047G>C c.G1047C W349C c.1048G>A c.G1048A A350T c.1048G>T c.G1048T A350S c.1049C>G c.C1049G A350G c.1049C>T c.C1049T A350V c.1052T>A c.T1052A V351E c.1052T>C c.T1052C V351A c.1054G>A c.G1054A A352T c.1054G>T c.G1054T A352S c.1055C>G c.C1055G A352G c.1055C>T c.C1055T A352V c.1057A>T c.A1057T M353L c.1058T>A c.T1058A M353K c.1058T>C c.T1058C M353T c.1061T>A c.T1061A I354K c.1061T>G c.T1061G I354R c.1063A>C c.A1063C N355H c.1063A>G c.A1063G N355D c.1063A>T c.A1063T N355Y c.1064A>G c.A1064G N355S c.1066C>G c.C1066G R356G c.1066C>T c.C1066T R356W c.1067G>A c.G1067A R356Q c.1067G>C c.G1067C R356P c.1067G>T c.G1067T R356L c.1069C>G c.C1069G Q357E c.1072G>C c.G1072C E358Q c.1073A>C c.A1073C E358A c.1073A>G c.A1073G E358G c.1074G>T or c.1074G>C c.G1074T or c.G1074C E358D c.1075A>C c.A1075C I359L c.1075A>G c.A1075G I359V c.1075A>T c.A1075T I359F c.1076T>A c.T1076A I359N c.1076T>C c.T1076C I359T c.1076T>G c.T1076G I359S c.1078G>A c.G1078A G360S c.1078G>C c.G1078C G360R c.1078G>T c.G1078T G360C c.1079G>A c.G1079A G360D c.1079G>C c.G1079C G360A c.1082G>A c.C1082A G361E c.1082G>C c.G1082C G361A c.1084C>A c.C1084A P362T c.1084C>G c.C1084G P362A c.1084C>T c.C1084T P362S c.1085C>A c.C1085A P362H c.1085C>G c.C1085G P362R c.1085C>T c.C1085T P362L c.1087C>A c.C1087A R363S c.1087C>G c.C1087G R363G c.1087C>T c.C1087T R363C c.1088G>A c.G1088A R363H c.1088G>T c.G1088T R363L c.1090T>C c.T1090C S364P c.1091C>G c.C1091G S364C c.1093T>A c.T1093A Y365N c.1093T>G c.T1093G Y365D c.1094A>C c.A1094C Y365S c.1094A>T c.A1094T Y365F c.1096A>C c.A1096C T366P c.1096A>T c.A1096T T366S c.1097C>A c.C1097A T366N c.1097C>T c.C1097T T366I c.1099A>C c.A1099C I367L c.1099A>T c.A1099T I367F c.1101C>G c.C1101G I367M c.1102G>A c.G1102A A368T c.1102G>C c.G1102C A368P c.1103C>G c.C1103G A368G c.1105G>A c.G1105A V369I c.1105G>C c.G1105C V369L c.1105G>T c.G1105T V369F c.1106T>C c.T1106C V369A c.1106T>G c.T1106G V369G c.1108G>A c.G1108A A370T c.1108G>C c.G1108C A370P c.1109C>A c.C1109A A370D c.1109C>G c.C1109G A370G c.1109C>T c.C1109T A370V c.1111T>A c.T1111A S371T c.1112C>G c.C1112G S371C c.1117G>A c.G1117A G373S c.1117G>T c.G1117T G373C c.1118G>C c.G1118C G373A c.1120A>G c.A1120G K374E c.1121A>C c.A1121C K374T c.1121A>G c.A1121G K374R c.1121A>T c.A1121T K374I c.1123G>C c.G1123C G375R c.1124G>A c.G1124A G375E c.1124G>C c.G1124C G375A c.1126G>A c.G1126A V376M c.1126G>C c.G1126C V376L c.1127T>A c.T1127A V376E c.1127T>G c.T1127G V376G c.1129G>A c.G1129A A377T c.1129G>C c.G1129C A377P c.1129G>T c.G1129T A377S c.1130C>G c.C1130G A377G c.1135A>G c.A1135G N379D c.1136A>C c.A1136C N379T c.1136A>T c.A1136T N379I c.1137T>A c.T1137A N379K c.1138C>A c.C1138A P380T c.1138C>G c.C1138G P380A c.1139C>A c.C1139A R380H c.1139C>G c.C1139G R380R c.1139C>T c.C1139T P380L c.1142C>A c.C1142A A381D c.1147T>A c.T1147A F383I c.1148T>A c.T1148A F383Y c.1148T>G c.T1148G F383C c.1150A>T c.A1150T I384F c.1151T>C c.T1151C I384T c.1152C>G c.C1152G I384M c.1153A>G c.A1153G T385A c.1154C>T c.C1154T T385I c.1156C>A c.C1156A Q386K c.1157A>T c.A1157T Q386L c.1158G>C c.G1158C Q386H c.1159C>A c.C1159A L387I c.1159C>T c.C1159T L387F c.1160T>A c.T1160A L387H c.1160T>G c.T1160G L387R c.1162C>A c.C1162A L388I c.1162C>G c.C1162G L388V c.1162C>T c.C1162T L388F c.1163T>A c.T1163A L388H c.1163T>G c.T1163G L388R c.1168G>A c.G1168A V390M c.1171A>C c.A1171C K391Q c.1171A>G c.A1171G K391E c.1172A>C c.A1172C K391T c.1172A>G c.A1172G K391R c.1172A>T c.A1172T K391I c.1173A>T c.A1173T K391N c.1174A>G c.A1174G R392G c.1774A>T c.A1174T R392W c.1175G>A c.G1175A R392K c.1175G>C c.G1175C R392T c.1175G>T c.G1175T R39M c.1177A>C c.A1177C K393Q c.1177A>G c.A1177G K393E c.1178A>C c.A1178C K393T c.1179G>C c.G1179C K393N c.1180C>A c.C1180A L394I c.1181T>A c.T1181A L394Q c.1181T>C c.T1181C L394P c.1181T>G c.T1181G L394R c.1183G>C c.G1183C G395R c.1184G>A c.G1184A G395E c.1184G>C c.G1184C G395A c.1186T>A c.T1186A F396I c.1186T>G c.T1186G F396V c.1187T>G c.T1187G F396C c.1188C>G c.C1188G F396L c.1189T>A c.T1189A Y397N c.1189T>C c.T1189C Y397H c.1190A>C c.A1190C Y397S c.1190A>G c.A1190G Y397C c.1190A>T c.A1190T Y397F c.1192G>A c.G1192A E398K c.1192G>C c.G1192C E398Q c.1193A>G c.A1193G E398G c.1195T>A c.T1195A W399R c.1195T>G c.T1195G W399G c.1198A>C c.A1198C T400P c.1198A>G c.A1198G T400A c.1198A>T c.A1198T T400S c.1199C>A c.C1199A T400N c.1199C>T c.C1199T T400I c.1201T>A c.T1201A S401T c.1201T>G c.T1201G S401A c.1202_1203insGACTTC c.1202_1203insGACTTC p.T400_S401dup c.1202C>T c.C1202T S2401L c.1204A>G c.A1204G R402G c.1204A>T c.A1204T R402W c.1205G>C c.G1205C R402T c.1205G>T c.G1205T R402M c.1206G>C c.G1206C R402S c.1207T>G c.T1207G L403V c.1208T>C c.T1208C L403S c.1209A>T c.A1209T L403F c.1210A>G c.A1210G R404G c.1211G>A c.G1211A R404K c.1211G>C c.G1211C R404T c.1211G>T c.G1211T R404I c.1212A>T c.A1212T R404S c.1213A>G c.A1213G S405G c.1216C>G c.C1216G H406D c.1217A>T c.A1217T H406L c.1218C>G c.C1218G H406Q c.1219A>T c.A1219T I407L c.1220T>C c.T1220C I407T c.1221A>G c.A1221G I407M c.1222A>C c.A1222C N408H c.1222A>G c.A1222G N408D c.1222A>T c.A1222T N408Y c.1223A>C c.A1223C N408T c.1225C>A c.C1225A P409T c.1225C>G c.C1225G P409A c.1225C>T c.C1225T P409S c.1226C>T c.C1226T P409L c.1228A>G c.A1228G T401A c.1228A>T c.A1238T T410S c.1229C>T c.C1229T T410I c.1231G>A c.G1231A G411S c.1231G>T c.G1231T G411C c.1232G>A c.G1232A G411D c.1232G>C c.G1232C G411A c.1232G>T c.G1232T G411V c.1234A>C c.A1234C T412P c.1234A>G c.A1234G T412A c.1234A>T c.A1234T T412S c.1235C>A c.C1235A T412N c.1235C>T c.C1235T T412I c.1237G>A c.G1237A V413I c.1237G>T c.G1237T V413F c.1238T>G c.T1238G V413G c.1240T>G c.T1240G L414V c.1242G>C c.G1242C L414F c.1243C>A c.C1243A L415I c.1244T>A c.T1244A L415H c.1246C>G c.C1246G Q416E c.1247A>T c.A1247T Q416L c.1248G>C c.G1248C Q416H c.1249C>A c.C1249A L417I c.1252G>A c.G1252A E418K c.1252G>C c.G1252C E418Q c.1253A>C c.A1253C E418A c.1253A>G c.A1253G E418G c.1254A>T c.A1254T E418D c.1255A>G c.A1255G N419D c.1255A>T c.A1255T N419Y c.1256A>C c.A1256C N419T c.1256A>G c.A1256G N419S c.1256A>T c.A1256T N419I c.1258A>C c.A1258C T420P c.1258A>T c.A1258T T420S c.1259C>A c.C1259A T420K c.1259C>G c.C1259G T420R c.1261A>G c.A1261G M421V c.1261A>T c.A1261T M421L c.1262T>A c.T1262A M421K c.1262T>C c.T1262C M421T c.1262T>G c.T1262G M421R c.1263G>C c.G1263C M421I c.1265A>C c.A1265C Q422P c.1267A>T c.A1267T M423L c.1268T>A c.T1268A M423K c.1268T>C c.T1268C M423T c.1269G>C c.G1269C M423I c.1271C>T c.C1271T S424L c.1275A>C c.A1275C L425F c.1279G>A c.G1279A D427N c.1286T>G c.T1286G L429R 

What is claimed is:
 1. A method of producing a batch of migalastat hydrochloride, the method comprising: performing a first crystallization step comprising dissolving intermediate grade migalastat hydrochloride in water and then adding ethanol to induce crystallization, providing a first crystallized migalastat hydrochloride; performing a second crystallization step comprising dissolving the first crystallized migalastat hydrochloride in water and then adding ethanol to induce crystallization, providing a second crystallized migalastat hydrochloride; and isolating the batch of migalastat hydrochloride.
 2. The method of claim 1, wherein the first crystallization comprises: dissolving the intermediate grade migalastat hydrochloride in water at a first crystallization temperature to provide dissolved intermediate grade migalastat; adding ethanol to the dissolved intermediate grade migalastat to induce crystallization, providing a slurry comprising a first crystallized migalastat hydrochloride; isolating the first crystallized migalastat hydrochloride when the slurry comprising the first crystallized migalastat hydrochloride reaches a first isolation temperature; filtering the first crystallized migalastat hydrochloride; washing the filtered first crystallized migalastat hydrochloride with ethanol; and drying the washed first crystallized migalastat hydrochloride.
 3. The method of claim 2, wherein the second crystallization comprises: dissolving the first crystallized migalastat hydrochloride in water at a second crystallization temperature to provide a second dissolved migalastat product; adding a first portion of ethanol to the second dissolved migalastat product to induce crystallization, providing a slurry comprising a second crystallized migalastat hydrochloride; adding a second portion of ethanol to the slurry comprising the second crystallized migalastat hydrochloride after a hold time; isolating the second crystallized migalastat hydrochloride when the slurry comprising the second crystallized migalastat hydrochloride reaches a second isolation temperature; filtering the second crystallized migalastat hydrochloride; washing the filtered second crystallized migalastat hydrochloride with ethanol; and drying the washed second crystallized migalastat hydrochloride to produce the batch of migalastat hydrochloride.
 4. The method of claim 1, wherein the intermediate grade migalastat hydrochloride, the first crystallized migalastat hydrochloride, or both, is dissolved in an amount of water which is from 1.0 to 1.6 times the weight of the corresponding migalastat hydrochloride.
 5. The method of claim 4, wherein the amount of water is from 1.1 to 1.4 times the weight of the corresponding migalastat hydrochloride.
 6. The method of claim 4, wherein the amount of water is 1.3 times the weight of the corresponding migalastat hydrochloride.
 7. The method of claim 3, wherein the first crystallization temperature, the second crystallization temperature, or both, is within a range from 30° C. to 60° C.
 8. The method of claim 7, wherein the first crystallization temperature, the second crystallization temperature, or both, is within a range from 40° C. to 60° C.
 9. The method of claim 7, wherein the first crystallization temperature, the second crystallization temperature, or both, is about 50° C.
 10. The method of claim 2, wherein the amount of ethanol added to the dissolved intermediate grade migalastat is from 1 to 11.4 times the weight of migalastat hydrochloride present in the dissolved intermediate grade migalastat.
 11. The method of claim 10, wherein a total amount of ethanol, added as the first and second portion of ethanol, is from 1 to 11.4 times the weight of migalastat hydrochloride present in the second dissolved migalastat product.
 12. The method of claim 11, wherein the amount of ethanol, the total amount of ethanol, or both, is from 4.8 to 11.4 times the weight of the corresponding migalastat hydrochloride.
 13. The method of claim 11, wherein the amount of ethanol, the total amount of ethanol, or both, is from 8.4 to 10.6 times the weight of the corresponding migalastat hydrochloride.
 14. The method of claim 11, wherein the amount of ethanol, the total amount of ethanol, or both, is about 9.5 times the weight of the corresponding migalastat hydrochloride.
 15. The method of claim 11, wherein the first portion of ethanol is 1.8 to 2.0 times the weight of the migalastat hydrochloride present in the second dissolved migalastat product.
 16. The method of claim 15, wherein the first portion of ethanol is 1.9 times the weight of the migalastat hydrochloride present in the second dissolved migalastat product.
 17. The method of claim 3, wherein the second portion of ethanol is 6.7 to 8.4 weights of ethanol times the weight of the migalastat hydrochloride present in the slurry comprising the second crystallized migalastat hydrochloride.
 18. The method of claim 3, wherein the first isolation temperature, the second isolation temperature, or both, is within a range from 5° C. to 35° C.
 19. The method of claim 18, wherein the first isolation temperature, the second isolation temperature, or both, is about 20° C.
 20. The method of claim 2, wherein the ethanol is added to the dissolved intermediate grade migalastat over a period from 0 to 65 minutes.
 21. The method of claim 20, wherein the ethanol is added over a period of 60 minutes.
 22. The method of claim 20, wherein the first portion of ethanol is added over a period from 5 minutes to 60 minutes.
 23. The method of claim 3, wherein the hold time is from 5 min to 60 min.
 24. The method of claim 1, wherein the batch of migalastat hydrochloride is pharmaceutical grade.
 25. The method of claim 3, wherein the batch of migalastat hydrochloride is pharmaceutical grade.
 26. A method of producing a batch of migalastat hydrochloride, the method comprising performing a first crystallization and a second crystallization, wherein: the first crystallization comprises: dissolving intermediate grade migalastat hydrochloride in water at a first crystallization temperature to produce dissolved intermediate grade migalastat hydrochloride; adding ethanol to the dissolved intermediate grade migalastat hydrochloride to induce crystallization, providing a slurry comprising a first crystallized migalastat hydrochloride; isolating the first crystallized migalastat hydrochloride; dissolving the first crystallized migalastat hydrochloride in water at a second crystallization temperature to produce a second dissolved migalastat product; adding a first portion of ethanol to the second dissolved migalastat product to induce crystallization, providing a slurry comprising a second crystallized migalastat hydrochloride; adding a second portion of ethanol to the slurry comprising the second crystallized migalastat hydrochloride after a hold time; and isolating the batch of migalastat hydrochloride.
 27. The method of claim 26, wherein the first crystallization temperature, the second crystallization temperature, or both, is within a range from 30° C. to 60° C.
 28. The method of claim 26, wherein the first isolation temperature, the second isolation temperature, or both, is within a range from 5° C. to 35° C.
 29. The method of claim 26, wherein the hold time is from 5 min to 60 min.
 30. The method of claim 26, wherein the batch of migalastat hydrochloride is pharmaceutical grade. 